Autism spectrum disorders (ASD) affect neurodevelopment and give rise to social and communication impairments accompanied by stereotyped patterns of behavior and interest. ASD affects 1/110 children and is a public health concern. ASD is not usually diagnosed until after the third birthday. Earlier detection is needed to provide access to intervention as early in life as possible because early intervention optimizes outcomes. The purpose of the proposed study is to identify very early indicators of ASD, beginning in infancy.
Specific aims are to: (1) define markers of disrupted neurobehavioral development that appear between 6 and 14 months of age, before clinical signs of ASD;(2) translate ASD clinical indicators identified in the second year of life into early ASD diagnostic criteria applicable to 1- and 2-year olds;and (3) define protective factors associated with outcomes in sibs-A to inform treatment approaches.
These aims will be achieved through the use of a prospective, longitudinal research design where assessments occur at regular intervals between 6 and 36 months. Participants will include younger siblings of children with autism (sibs-A) who are at high genetic risk for ASD as well as language and social delays;preterm infants, who are at high risk for developmental delays but lower risk for ASD than sibs-A;and younger siblings of children with typical development who are deemed to be at low risk for developing ASD. At 36 months, children will receive confirmatory outcome classification into one of three groups: ASD;Non-ASD Delay;and No Delays. Measures administered at each age assess visual attention to social and non-social stimuli, motor and communication development, object exploration, understanding of others'intended actions, and ASD symptoms. Statistical analyses will include ANOVA, Pearson's correlation, Classification and Regression Trees, regression models, and propensity score methods. High-impact findings are anticipated. Based on discoveries from this study about the nature of very early disruptions in development, new ASD screeners for infants and toddlers may be developed that are more sensitive and specific than existing tools. In addition, proposals for the content and instructional methods used in very early interventions will be made. Such interventions may prevent aspects of the ASD phenotype from emerging, or dampen the severity of expression of the disorder.

Public Health Relevance

Autism is a disorder that affects approximately 1 of every 110 children and that is characterized by deficits in social interaction and communication, as well as repetitive behaviors and routines. Early intervention improves outcomes for children with autism, but most children with autism are not diagnosed until 3 years of age or older. In order to make it possible to detect autism earlier in life, this proposal will focus on identifying indicators of rik for ASD, and criteria for very early diagnosis of autism by assessing infants, from 6 to 36 months, at high risk for autism, at high risk for developmental delays other than autism, and at low risk for autism.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH059630-13
Application #
8664918
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Gilotty, Lisa
Project Start
2001-09-25
Project End
2017-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
13
Fiscal Year
2014
Total Cost
$675,162
Indirect Cost
$257,364
Name
Hugo W. Moser Research Institute Kennedy Krieger
Department
Type
DUNS #
155342439
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Rao, Patricia A; Landa, Rebecca J (2014) Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Autism 18:272-80
Libertus, Klaus; Sheperd, Kelly A; Ross, Samuel W et al. (2014) Limited fine motor and grasping skills in 6-month-old infants at high risk for autism. Child Dev 85:2218-31
Zwaigenbaum, Lonnie; Young, Gregory S; Stone, Wendy L et al. (2014) Early head growth in infants at risk of autism: a baby siblings research consortium study. J Am Acad Child Adolesc Psychiatry 53:1053-62
Messinger, Daniel; Young, Gregory S; Ozonoff, Sally et al. (2013) Beyond autism: a baby siblings research consortium study of high-risk children at three years of age. J Am Acad Child Adolesc Psychiatry 52:300-308.e1
Libertus, Klaus; Landa, Rebecca J (2013) The Early Motor Questionnaire (EMQ): a parental report measure of early motor development. Infant Behav Dev 36:833-42
Landa, Rebecca J; Gross, Alden L; Stuart, Elizabeth A et al. (2013) Developmental trajectories in children with and without autism spectrum disorders: the first 3ýýyears. Child Dev 84:429-42
Hess, Christine Reiner; Landa, Rebecca J (2012) Predictive and concurrent validity of parent concern about young children at risk for autism. J Autism Dev Disord 42:575-84
Bhat, A N; Galloway, J C; Landa, R J (2010) Social and non-social visual attention patterns and associative learning in infants at risk for autism. J Child Psychol Psychiatry 51:989-97
Kalb, Luther G; Law, J K; Landa, Rebecca et al. (2010) Onset patterns prior to 36 months in autism spectrum disorders. J Autism Dev Disord 40:1389-402
Landa, Rebecca J (2008) Diagnosis of autism spectrum disorders in the first 3 years of life. Nat Clin Pract Neurol 4:138-47

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