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Will EA, Hills KJ, Smith K, McQuillin S, Roberts JE. Developmental associations between motor and communication outcomes in Fragile X syndrome: Variation in the context of co-occurring autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225498. [PMID: 38456297 DOI: 10.1177/13623613231225498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
LAY ABSTRACT Fragile X syndrome (FXS), the leading heritable cause of intellectual disability, has a co-occurrence rate of autism spectrum disorder (ASD) estimated at ~60%. Children with FXS experience delayed achievement and slower development of key motor abilities, which happens to an even greater extent for children with both FXS and ASD. A multitude of studies have demonstrated that motor abilities are foundational skills related to later communication outcomes in neurotypical development, as well as in the context of ASD. However, these associations remain unexamined in FXS, or FXS + ASD. In this study, we aimed to determine the associations between early motor skills and their rate of development on communication outcomes in FXS. Furthermore, we investigated whether these associations varied in the context of co-occurring FXS + ASD. Results revealed within-FXS variation in the context of co-occurring ASD between some aspects of motor development and communication outcomes, yet within-FXS consistency between others. Findings provide evidence for variability in developmental processes and outcomes in FXS in the context of co-occurring ASD and offer implications for intervention.
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Mundy P. Research on social attention in autism and the challenges of the research domain criteria (RDoC) framework. Autism Res 2023; 16:697-712. [PMID: 36932883 DOI: 10.1002/aur.2910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
The fuzzy nature of categories of psychopathology, such as autism, leads to significant research challenges. Alternatively, focusing research on the study of a common set of important and well-defined psychological constructs across psychiatric conditions may make the fundamental etiological processes of psychopathology easier to discern and treat (Cuthbert, 2022). The development of the research domain criteria (RDoC) framework is designed to guide this new research approach (Insel et al., 2010). However, progress in research may be expected to continually refine and reorganize the understanding of the specifics of these mental processes (Cuthbert & Insel, 2013). Moreover, knowledge gleaned from the study of both normative and atypical development can be mutually informative in the evolution of our understanding of these fundamental processes. A case in point is the study of social attention. This Autism 101 commentary provides an educational summary of research over the last few decades indicates that social attention is major construct in the study of human social-cognitive development, autism and other forms of psychopathology. The commentary also describes how this research can inform the Social Process dimension of the RDoC framework.
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Affiliation(s)
- Peter Mundy
- School of Education, Department of Psychiatry and the MIND Institute, University of California at Davis, Davis, California, USA
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Dawson G, Rieder AD, Johnson MH. Prediction of autism in infants: progress and challenges. Lancet Neurol 2023; 22:244-254. [PMID: 36427512 PMCID: PMC10100853 DOI: 10.1016/s1474-4422(22)00407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/17/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Autism spectrum disorder (henceforth autism) is a neurodevelopmental condition that can be reliably diagnosed in children by age 18-24 months. Prospective longitudinal studies of infants aged 1 year and younger who are later diagnosed with autism are elucidating the early developmental course of autism and identifying ways of predicting autism before diagnosis is possible. Studies that use MRI, EEG, and near-infrared spectroscopy have identified differences in brain development in infants later diagnosed with autism compared with infants without autism. Retrospective studies of infants younger than 1 year who received a later diagnosis of autism have also showed an increased prevalence of health conditions, such as sleep disorders, gastrointestinal disorders, and vision problems. Behavioural features of infants later diagnosed with autism include differences in attention, vocalisations, gestures, affect, temperament, social engagement, sensory processing, and motor abilities. Although research findings offer insight on promising screening approaches for predicting autism in infants, individual-level predictions remain a future goal. Multiple scientific challenges and ethical questions remain to be addressed to translate research on early brain-based and behavioural predictors of autism into feasible and reliable screening tools for clinical practice.
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Affiliation(s)
- Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Amber D Rieder
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK; Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
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Hoffmann A. Communication in fragile X syndrome: Patterns and implications for assessment and intervention. Front Psychol 2022; 13:929379. [PMID: 36619013 PMCID: PMC9817301 DOI: 10.3389/fpsyg.2022.929379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and is associated with a high rate of autism diagnosis. Language delays have been noted in the areas of overall communication and the specific areas of receptive, expressive, and pragmatic language, as well as in development of speech sounds and literacy. It has been widely noted that those individuals with a diagnosis of both FXS and autism tend to have more significant intellectual disability and language disorder. In this study, the research exploring the FXS language phenotype is presented, and the roles of cognition, autistic symptomatology, and gender are highlighted as possible. Implications for assessment and intervention approaches based on the strengths and weaknesses of the FXS language phenotype are provided.
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Affiliation(s)
- Anne Hoffmann
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, IL, United States,Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States,*Correspondence: Anne Hoffmann,
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Thurman AJ, Dimachkie Nunnally A. Joint attention performance in preschool-aged boys with autism or fragile X syndrome. Front Psychol 2022; 13:918181. [PMID: 36003114 PMCID: PMC9393518 DOI: 10.3389/fpsyg.2022.918181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Early development marks a period of rapid learning facilitated by children's natural curiosity about the people around them. In children with typical development, these early social attentional preferences set the foundation for learning about and from the surrounding world of people. Much of this learning happens using joint attention, the ability to coordinate attention between people and objects of mutual interest. It is well documented that decreased gaze use is commonly observed in individuals with autism and individuals with fragile X syndrome (FXS). Despite the growing body of research comparing phenotypic similarities between individuals with autism and individuals with FXS, no studies have directly compared joint attention performance between these groups. In the present study, we considered the similarities and differences in joint attention between preschool-aged boys with autism or FXS, and the relation between joint attention, language, and other phenotypic characteristics known to differ between boys with autism and boys with FXS. Although joint attention appeared similar, between-group differences emerged when controlling for the influence of age, non-verbal IQ, and autism symptom severity. Differences were also observed when considering how joint attention performance related to other aspects of the phenotype. For example, strong positive associations were observed between joint attention and language performance in boys with autism but not boys with FXS, even after controlling for non-verbal IQ. In contrast, the negative association between joint attention and anxiety symptom severity was significant and stronger in boys with FXS than in autism. These data offer preliminary insights into the similarities and differences between the autism and FXS phenotypes.
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Affiliation(s)
- Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States,Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, CA, United States,*Correspondence: Angela John Thurman,
| | - Amanda Dimachkie Nunnally
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States,Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, CA, United States
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Montagut-Asunción M, Crespo-Martín S, Pastor-Cerezuela G, D’Ocon-Giménez A. Joint Attention and Its Relationship with Autism Risk Markers at 18 Months of Age. CHILDREN 2022; 9:children9040556. [PMID: 35455600 PMCID: PMC9027970 DOI: 10.3390/children9040556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
(1) Joint attention is the ability to coordinate attention to share a point of reference with another person. It has an early onset and is a clear indicator of understanding the representations of others, and it is essential in the development of symbolic thought and the acquisition of language. Deficiencies in this prelinguistic early communication skill are strong markers of the risk of autism spectrum disorder (ASD); (2) this longitudinal study aimed to evaluate joint attention skills in a group of 32 infants at two developmental moments (8 and 12 months) in order to explore whether their performance on this skill was related to the presence of early signs of ASD at 18 months. Logistic multiple regressions were carried out for the data analysis; (3) results of the analysis showed that the variables of initiating joint attention at 8 months and responding to joint attention at 12 months were linked to the risk of ASD at 18 months of age; (4) in conclusion, early joint attention skills had a pivotal role in defining early manifestations of ASD.
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Affiliation(s)
- Maite Montagut-Asunción
- Department of Neuropsychobiology, Methodology, and Basic and Social Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Burjassot, Valencia, Spain;
| | - Sarah Crespo-Martín
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
| | - Gemma Pastor-Cerezuela
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
- Correspondence:
| | - Ana D’Ocon-Giménez
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
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Ellis K, Moss J, Stefanidou C, Oliver C, Apperly I. The development of early social cognitive skills in neurogenetic syndromes associated with autism: Cornelia de Lange, fragile X and Rubinstein-Taybi syndromes. Orphanet J Rare Dis 2021; 16:488. [PMID: 34809685 PMCID: PMC8607585 DOI: 10.1186/s13023-021-02117-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cornelia de Lange (CdLS), Fragile X (FXS) and Rubinstein-Taybi syndromes (RTS) evidence unique profiles of autistic characteristics. To delineate these profiles further, the development of early social cognitive abilities in children with CdLS, FXS and RTS was compared to that observed in typically developing (TD) and autistic (AUT) children. METHODS Children with CdLS (N = 22), FXS (N = 19) and RTS (N = 18), completed the Early Social Cognition Scale (ESCogS). Extant data from AUT (N = 19) and TD (N = 86) children were used for comparison. RESULTS Similar to AUT children, children with CdLS, FXS and RTS showed an overall delay in passing ESCogS tasks. Children with CdLS showed a similar degree of delay to AUT children and greater delay than children with FXS and RTS. The CdLS, FXS and RTS groups did not pass tasks in the same sequence observed in TD and AUT children. Children with CdLS (p = 0.04), FXS (p = 0.02) and RTS (p = 0.04) performed better on tasks requiring understanding simple intentions in others significantly more than tasks requiring joint attention skills. CONCLUSIONS An underlying mechanism other than general cognitive delay may be disrupting early social cognitive development in children with CdLS, FXS and RTS. Factors that may disrupt early social cognitive development within these syndromes are discussed.
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Affiliation(s)
- Katherine Ellis
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
- School of Psychology, University of Surrey, Guildford, Surrey, GU26 7XH, UK.
| | - Jo Moss
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- School of Psychology, University of Surrey, Guildford, Surrey, GU26 7XH, UK
| | - Chrysi Stefanidou
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Rivermead Campus, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Ian Apperly
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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Will EA, Roberts JE. Motor Influences on Communication: Comparisons Between Down Syndrome and Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:460-476. [PMID: 34700347 PMCID: PMC8764748 DOI: 10.1352/1944-7558-126.6.460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 01/19/2021] [Indexed: 06/13/2023]
Abstract
Motor skills, an important foundation for language and communication, are considerably delayed in children with Down syndrome (DS) and fragile X syndrome (FXS). However, the impact of these impairments on expressive and receptive communication and the phenotypic specificity of these associations remains unknown. Participants included 37 with DS and 37 age and developmentally matched children with FXS. Syndrome-specific motor and communication profiles emerged, with higher communication scores seen in the DS versus FXS on, but lower gross motor scores. Significant associations between domains of motor and communication were identified for both groups with additional phenotype-specific patterns. Findings demonstrate the importance of early motor abilities for communication in DS and FXS. Implications for phenotypic specificity and targeted intervention are discussed.
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Affiliation(s)
- Elizabeth A. Will
- Corresponding Author: Dr. Elizabeth A. Will, Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, South Carolina, 29208 ()
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Abstract
Prospective longitudinal studies of idiopathic autism spectrum disorder (ASD) have provided insights into early symptoms and predictors of ASD during infancy, well before ASD can be diagnosed at age 2-3 years. However, research on the emergence of ASD in disorders with a known genetic etiology, contextualized in a developmental framework, is currently lacking. Using a biobehavioral multimethod approach, we (a) determined the rate of ASD in N = 51 preschoolers with fragile X syndrome (FXS) using a clinical best estimate (CBE) procedure with differential diagnoses of comorbid psychiatric disorders and (b) investigated trajectories of ASD symptoms and physiological arousal across infancy as predictors of ASD in preschoolers with FXS. ASD was not diagnosed if intellectual ability or psychiatric disorders better accounted for the symptoms. Our results determined that 60.7% of preschoolers with FXS met the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5) criteria for ASD using the CBE procedure. In addition, 92% of these preschoolers presented with developmental delay and 45.4% also met criteria for psychiatric disorders, either anxiety, ADHD, or both. ASD diagnoses in preschoolers with FXS were predicted by elevated scores on traditional ASD screeners in addition to elevated autonomic arousal and avoidant eye contact from infancy.
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Guy J, Ng-Cordell E, Doherty BR, Duta M, Scerif G. Understanding attention, memory and social biases in fragile X syndrome: Going below the surface with a multi-method approach. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103693. [PMID: 32505967 DOI: 10.1016/j.ridd.2020.103693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 06/11/2023]
Abstract
Fragile X syndrome (FXS) is characterised by atypical social behaviours, such as gaze aversion. However, it remains unclear whether, or if so how, these behaviours affect cognitive processing and influence memory. We asked children with FXS (N = 16) and typically developing children (TD; N = 46) to explore naturalistic scenes containing social and non-social salient items unrelated to their task at hand (searching for a simple target object). We also assessed children's memory for target locations. We complemented behavioural responses with eye-tracking data for the subset of participants who managed to comply with calibration and the demands of the experimental testing session (6 children with FXS and 43 TD children). Children with FXS performed well at the experimental task, and showed similar accuracy and speed in locating targets in natural scenes to children of equivalent verbal abilities. They also learned target locations over blocks, but their memory of target locations was not as precise as that of comparison children. In addition, children with FXS initially directed few first looks to salient social items within the scenes, but these looks increased over blocks. Like TD children, children with FXS also dwelled gaze upon social items while recalling target locations from memory. Individual differences in everyday social characteristics also related to gaze and behavioural measures. In conclusion, experimental approaches can highlight cognitive underpinnings of atypical social behaviour in FXS, pinpointing both similarities and differences to TD individuals.
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Affiliation(s)
- Jacalyn Guy
- Department of Experimental Psychology, University of Oxford, United Kingdom; MRC Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Elise Ng-Cordell
- Department of Experimental Psychology, University of Oxford, United Kingdom; MRC Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Brianna Ruth Doherty
- Department of Experimental Psychology, University of Oxford, United Kingdom; Medical School, University of California at San Francisco, United States
| | - Mihaela Duta
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, United Kingdom.
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