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Uljarević M, Bott NT, Libove RA, Phillips JM, Parker KJ, Hardan AY. Characterizing Emotion Recognition and Theory of Mind Performance Profiles in Unaffected Siblings of Autistic Children. Front Psychol 2022; 12:736324. [PMID: 35283803 PMCID: PMC8907847 DOI: 10.3389/fpsyg.2021.736324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
Emotion recognition skills and the ability to understand the mental states of others are crucial for normal social functioning. Conversely, delays and impairments in these processes can have a profound impact on capability to engage in, maintain, and effectively regulate social interactions. Therefore, this study aimed to compare the performance of 42 autistic children (Mage = 8.25 years, SD = 2.22), 45 unaffected siblings (Mage = 8.65 years, SD = 2.40), and 41 typically developing (TD) controls (Mage = 8.56 years, SD = 2.35) on the Affect Recognition (AR) and Theory of Mind (TOM) subtests of the Developmental Neuropsychological Assessment Battery. There were no significant differences between siblings and TD controls. Autistic children showed significantly poorer performance on AR when compared to TD controls and on TOM when compared to both TD controls and unaffected siblings. An additional comparison of ASD, unaffected sibling and TD control subsamples, matched on full-scale IQ, revealed no group differences for either AR or TOM. AR and TOM processes have received less research attention in siblings of autistic children and remain less well characterized. Therefore, despite limitations, findings reported here contribute to our growing understanding of AR and TOM abilities in siblings of autistic children and highlight important future research directions.
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Affiliation(s)
- Mirko Uljarević
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
- Department of Psychology and Counseling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Nicholas T. Bott
- Department of Medicine, Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, CA, United States
- PGSP-Stanford Consortium, Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
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2
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Norcia AM, Lee A, Meredith WJ, Kohler PJ, Pei F, Ghassan SA, Libove RA, Phillips JM, Hardan AY. A case-control study of visual, auditory and audio-visual sensory interactions in children with autism spectrum disorder. J Vis 2021; 21:5. [PMID: 33830169 PMCID: PMC8039569 DOI: 10.1167/jov.21.4.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/09/2020] [Indexed: 01/23/2023] Open
Abstract
To assess the relative integrity of early visual and auditory processes in autism spectrum disorder (ASD), we used frequency-tagged visual and auditory stimulation and high-density electroencephalogram recordings of unimodal and dual-modality responses in a case-control design. To test for the specificity of effects on ASD, we recorded from a smaller group of children with attention-deficit hyperactivity disorder (ADHD). Horizontal 3 cycle per degree (cpd) gratings were presented at 5 Hz, and a random stream of /ba/, /da/, /ga/ syllables was presented at 6 Hz. Grating contrast response functions were measured unimodally and in the presence of a 64-dB auditory input. Auditory response functions were measured unimodally and in the presence of a 40% contrast grating. Children with ASD (n = 34) and ADHD (n = 13) showed a common lack of audio-visual interaction compared to typically developing children (n = 40) when measured at the first harmonic of the visual stimulus frequency. Both patient groups also showed depressed first harmonic responses at low contrast, but the ADHD group had consistently higher first-harmonic responses at high contrast. Children with ASD had a preferential loss of second-harmonic (transient) responses. The alteredtransient responses in ASD are likely to arise very early in the visual pathway and could thus have downstream consequences for many other visual mechanisms and processes. The alteration in audio-visual interaction could be a signature of a comorbid phenotype shared by ASD and ADHD, possibly due to alterations in attentional selection systems.
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Affiliation(s)
- Anthony M Norcia
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Azalea Lee
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | - Peter J Kohler
- Department of Psychology, York University, Toronto, ON, Canada
- Centre for Vision Research, York University, Toronto, ON, Canada
| | - Francesca Pei
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Stephanie A Ghassan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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3
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Steele M, Uljarević M, Rached G, Frazier TW, Phillips JM, Libove RA, Busch RM, Klaas P, Martinez-Agosto JA, Srivastava S, Eng C, Sahin M, Hardan AY. Psychiatric Characteristics Across Individuals With PTEN Mutations. Front Psychiatry 2021; 12:672070. [PMID: 34489750 PMCID: PMC8418135 DOI: 10.3389/fpsyt.2021.672070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Germline heterozygous PTEN mutations have been associated with high prevalence of autism spectrum disorder (ASD) and elevated rates and severity of broadly defined behavioral problems. However, limited progress has been made toward understanding whether PTEN mutation is associated with specific psychiatric co-morbidity profiles when compared to idiopathic ASD. The current study aimed to utilize a cross-measure approach to compare concurrent psychiatric characteristics across children and adolescents with PTEN mutation with (PTEN-ASD; n = 38) and without ASD (PTEN-No ASD; n = 23), and ASD with macrocephaly but no PTEN mutation (macro-ASD; n = 25) using the Child Behavior Checklist (CBCL) and the Aberrant Behavior Checklist (ABC). There were significant group effects for the CBCL Internalizing and Externalizing broad symptom score, the majority of specific CBCL syndrome scores, and all ABC subscale scores. Post-hoc comparisons revealed greater behavioral symptoms in the ASD groups (PTEN-ASD and macro-ASD) compared to the PTEN-no ASD group on nearly all subtest scores examined. There were no statistically significant differences between the PTEN-ASD and macro-ASD groups; however, there was a trend for the macro-ASD group showing higher levels of aggressive behaviors. Our findings provide evidence of specific behavior profiles across PTEN-No ASD, PTEN-ASD, and macro-ASD groups and highlight the importance of early identification of behavioral vulnerabilities in individuals with PTEN mutations in order to provide access to appropriate evidence-based interventions.
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Affiliation(s)
- Morgan Steele
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Mirko Uljarević
- The School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.,La Trobe University, Melbourne, VIC, Australia
| | - Gaëlle Rached
- Saint Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - Thomas W Frazier
- Autism Speaks, New York, NY, United States.,Department of Psychology, John Carroll University, University Heights, OH, United States
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robyn M Busch
- Genomic Medicine Institute, Cleveland, OH, United States.,Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Patricia Klaas
- Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Julian A Martinez-Agosto
- Departments of Human Genetics, Pediatrics and Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Siddharth Srivastava
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Charis Eng
- Genomic Medicine Institute, Cleveland, OH, United States.,Department of Genetics and Genome Sciences, Case Western University School of Medicine, Cleveland, OH, United States
| | - Mustafa Sahin
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
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Itskovich E, Zyga O, Libove RA, Phillips JM, Garner JP, Parker KJ. Complex Interplay Between Cognitive Ability and Social Motivation in Predicting Social Skill: A Unique Role for Social Motivation in Children With Autism. Autism Res 2020; 14:86-92. [DOI: 10.1002/aur.2409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/28/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Elena Itskovich
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Olena Zyga
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
- Department of Comparative Medicine Stanford University Stanford California USA
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
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Uljarević M, Phillips JM, Schuck RK, Schapp S, Solomon EM, Salzman E, Allerhand L, Libove RA, Frazier TW, Hardan AY. Exploring Social Subtypes in Autism Spectrum Disorder: A Preliminary Study. Autism Res 2020; 13:1335-1342. [DOI: 10.1002/aur.2294] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
- Melbourne School of Psychological Sciences Faculty of Medicine, Dentistry, and Health SciencesThe University of Melbourne Victoria Australia
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Rachel K. Schuck
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Salena Schapp
- Department of PsychiatryKaiser Permanente Redwood City California USA
| | - Elizabeth M. Solomon
- Department of Psychiatry and Behavioral Sciences, Davis Medical CenterUniversity of California Sacramento California USA
| | - Emma Salzman
- Department of PsychiatryUniversity of California San Francisco San Francisco California USA
| | - Lauren Allerhand
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Thomas W. Frazier
- Autism Speaks New York USA
- Department of PsychologyJohn Carroll University, University Heights Ohio USA
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
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Phillips JM, Uljarević M, Schuck RK, Schapp S, Solomon EM, Salzman E, Allerhand L, Libove RA, Frazier TW, Hardan AY. Development of the Stanford Social Dimensions Scale: initial validation in autism spectrum disorder and in neurotypicals. Mol Autism 2019; 10:48. [PMID: 31890146 PMCID: PMC6921422 DOI: 10.1186/s13229-019-0298-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/15/2019] [Indexed: 11/22/2022] Open
Abstract
Background The aim of this paper was to provide an initial validation of a newly developed parent questionnaire-the Stanford Social Dimensions Scale (SSDS), designed to capture individual differences across several key social dimensions including social motivation in children and adolescents with and without psychiatric disorders. Methods The initial validation sample was comprised of parents of 175 individuals with autism spectrum disorder (ASD) (35 females, 140 males; Mage = 7.19 years, SDage = 3.96) and the replication sample consisted of 624 parents of children who were either typically developing or presented with a range of neurodevelopmental and neuropsychiatric disorders (302 females, 322 males; Mage = 11.49 years, SDage = 4.48). Parents from both samples completed the SSDS and the Social Responsiveness Scale (SRS-2). Results Exploratory Structural Equation Modeling indicated that a 5-factor model provided adequate to excellent fit to the data in the initial ASD sample (comparative fit index [CFI] = .940, Tucker-Lewis Index [TLI] = .919, root mean square error of approximation [RMSEA] = .048, standardized root mean square residual [SRMR] = .038). The identified factors were interpreted as Social Motivation, Social Affiliation, Expressive Social Communication, Social Recognition, and Unusual Approach. This factor structure was further confirmed in Sample 2 (CFI = 946, TLI = .930, RMSEA = .044, SRMR = .026). Internal consistency for all subscales was in the good to excellent range across both samples as indicated by Composite Reliability scores of ≥ .72. Convergent and divergent validity was strong as indexed by the pattern of correlations with relevant SRS-2 and Child Behavior Checklist domains and with verbal and non-verbal intellectual functioning scores in Sample 1 and with the Need to Belong Scale and Child Social Preference Scale scores in Sample 2. Across both samples, females had higher social motivation and expressive social communication scores. Discriminant validity was strong given that across all SSDS subscales, the ASD sample had significantly higher impairment than both the typically developing group and the group with other clinical conditions, which in turn, had significantly higher impairment than the typically developing group. Conclusions Our findings provide initial validation of a new scale designed to comprehensively capture individual differences in social motivation and other key social dimensions in ASD.
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Affiliation(s)
- Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Rachel K. Schuck
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Salena Schapp
- Department of Psychiatry, Kaiser Permanente, Redwood City, CA USA
| | - Elizabeth M. Solomon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA USA
| | - Emma Salzman
- Department of Psychiatry, University of California San Francisco, San Francisco, CA USA
| | - Lauren Allerhand
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | | | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
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7
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Mariscal MG, Oztan O, Rose SM, Libove RA, Jackson LP, Sumiyoshi RD, Trujillo TH, Carson DS, Phillips JM, Garner JP, Hardan AY, Parker KJ. Blood oxytocin concentration positively predicts contagious yawning behavior in children with autism spectrum disorder. Autism Res 2019; 12:1156-1161. [PMID: 31132232 DOI: 10.1002/aur.2135] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/29/2019] [Indexed: 01/13/2023]
Abstract
Research suggests that children with autism spectrum disorder (ASD) may have reduced empathy, as measured by an impaired contagious yawn response, compared to typically developing (TD) children. Other research has failed to replicate this finding, instead attributing this phenomenon to group differences in attention paid to yawn stimuli. A third possibility is that only a subgroup of children with ASD exhibits the impaired contagious yawn response, and that it can be identified biologically. Here we quantified blood concentrations of the "social" neuropeptide oxytocin (OXT) and evaluated yawning behavior and attention rates during a laboratory task in children with ASD (N = 34) and TD children (N = 30) aged 6-12 years. No group difference in contagious yawning behavior was found. However, a blood OXT concentration × group (ASD vs. TD) interaction positively predicted contagious yawning behavior (F1,50 = 7.4987; P = 0.0085). Specifically, blood OXT concentration was positively related to contagious yawning behavior in children with ASD, but not in TD children. This finding was not due to delayed perception of yawn stimuli and was observed whether attention paid to test stimuli and clinical symptom severity were included in the analysis or not. These findings suggest that only a biologically defined subset of children with ASD exhibits reduced empathy, as measured by the impaired contagious yawn response, and that prior conflicting reports of this behavioral phenomenon may be attributable, at least in part, to variable mean OXT concentrations across different ASD study cohorts. Autism Res 2019, 12: 1156-1161. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: People with autism may contagiously yawn (i.e., yawn in response to another's yawn) less often than people without autism. We find that people with autism who have lower levels of blood oxytocin (OXT), a hormone involved in social behavior and empathy, show decreased contagious yawning, but those who have higher blood OXT levels do not differ in contagious yawning from controls. This suggests that decreased contagious yawning may only occur in a biologically defined subset of people with autism.
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Affiliation(s)
- Michael G Mariscal
- Program in Human Biology, Stanford University, Stanford, California.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Ozge Oztan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Sophie M Rose
- Program in Human Biology, Stanford University, Stanford, California.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Lisa P Jackson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Raena D Sumiyoshi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Tara H Trujillo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Dean S Carson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Joseph P Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.,Department of Comparative Medicine, Stanford University, Stanford, California
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Karen J Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
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Parker KJ, Oztan O, Libove RA, Mohsin N, Karhson DS, Sumiyoshi RD, Summers JE, Hinman KE, Motonaga KS, Phillips JM, Carson DS, Fung LK, Garner JP, Hardan AY. A randomized placebo-controlled pilot trial shows that intranasal vasopressin improves social deficits in children with autism. Sci Transl Med 2019; 11:scitranslmed.aau7356. [PMID: 31043522 DOI: 10.1126/scitranslmed.aau7356] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/30/2018] [Accepted: 01/26/2019] [Indexed: 01/26/2023]
Abstract
The social impairments of autism spectrum disorder (ASD) have a major impact on quality of life, yet there are no medications that effectively treat these core social behavior deficits. Preclinical research suggests that arginine vasopressin (AVP), a neuropeptide involved in promoting mammalian social behaviors, may be a possible treatment for ASD. Using a double-blind, randomized, placebo-controlled, parallel study design, we tested the efficacy and tolerability of a 4-week intranasal AVP daily treatment in 30 children with ASD. AVP-treated participants aged 6 to 9.5 years received the maximum daily target dose of 24 International Units (IU); participants aged 9.6 to 12.9 years received the maximum daily target dose of 32 IU. Intranasal AVP treatment compared to placebo enhanced social abilities as assessed by change from baseline in this phase 2 trial's primary outcome measure, the Social Responsiveness Scale, 2nd Edition total score (SRS-2 T score; F 1,20 = 9.853; P = 0.0052; ηp 2 = 33.0%; Cohen's d = 1.40). AVP treatment also diminished anxiety symptoms and some repetitive behaviors. Most of these findings were more pronounced when we accounted for pretreatment AVP concentrations in blood. AVP was well tolerated with minimal side effects. No AVP-treated participants dropped out of the trial, and there were no differences in the rate of adverse events reported between treatment conditions. Last, no changes from baseline were observed in vital signs, electrocardiogram tracings, height and body weight, or clinical chemistry measurements after 4 weeks of AVP treatment. These preliminary findings suggest that AVP has potential for treating social impairments in children with ASD.
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Affiliation(s)
- Karen J Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA.
| | - Ozge Oztan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Noreen Mohsin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Debra S Karhson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Raena D Sumiyoshi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Jacqueline E Summers
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Kyle E Hinman
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Kara S Motonaga
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Dean S Carson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Lawrence K Fung
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Joseph P Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA.,Department of Comparative Medicine, Stanford University, Stanford, CA 94305, USA
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
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9
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Gengoux GW, Schapp S, Burton S, Ardel CM, Libove RA, Baldi G, Berquist KL, Phillips JM, Hardan AY. Effects of a parent-implemented Developmental Reciprocity Treatment Program for children with autism spectrum disorder. Autism 2018; 23:713-725. [PMID: 29775078 DOI: 10.1177/1362361318775538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Developmental approaches to autism treatment aim to establish strong interpersonal relationships through joint play. These approaches have emerging empirical support; however, there is a need for further research documenting the procedures and demonstrating their effectiveness. This pilot study evaluated changes in parent behavior and child autism symptoms following a 12-week Developmental Reciprocity Treatment parent-training program. A total of 22 children with autism spectrum disorder between 2 and 6 years (mean age = 44.6 months, standard deviation = 12.7) and a primary caregiver participated in 12 weekly sessions of Developmental Reciprocity Treatment parent training, covering topics including introduction to developmental approaches, supporting attention and motivation, sensory regulation and sensory-social routines, imitation/building nonverbal communication, functional language development, and turn taking. Results indicated improvement in aspects of parent empowerment and social quality of life. Improvement in core autism symptoms was observed on the Social Responsiveness Scale total score (F(1,19): 5.550, p = 0.029), MacArthur-Bates Communicative Development Inventories number of words produced out of 680 (F(1,18): 18.104, p = 0.000), and two subscales of the Repetitive Behavior Scale, Revised (compulsive, p = 0.046 and restricted, p = 0.025). No differences in sensory sensitivity were observed on the Short Sensory Profile. Findings from this pilot study indicate that Developmental Reciprocity Treatment shows promise and suggest the need for future controlled trials of this developmentally based intervention.
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Affiliation(s)
| | | | | | | | | | - Gina Baldi
- 1 Stanford University, USA.,3 Children's Health Council, USA
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10
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Karhson DS, Krasinska KM, Dallaire JA, Libove RA, Phillips JM, Chien AS, Garner JP, Hardan AY, Parker KJ. Plasma anandamide concentrations are lower in children with autism spectrum disorder. Mol Autism 2018; 9:18. [PMID: 29564080 PMCID: PMC5848550 DOI: 10.1186/s13229-018-0203-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/05/2018] [Indexed: 11/22/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by restricted, stereotyped behaviors and impairments in social communication. Although the underlying biological mechanisms of ASD remain poorly understood, recent preclinical research has implicated the endogenous cannabinoid (or endocannabinoid), anandamide, as a significant neuromodulator in rodent models of ASD. Despite this promising preclinical evidence, no clinical studies to date have tested whether endocannabinoids are dysregulated in individuals with ASD. Here, we addressed this critical gap in knowledge by optimizing liquid chromatography-tandem mass spectrometry methodology to quantitatively analyze anandamide concentrations in banked blood samples collected from a cohort of children with and without ASD (N = 112). Findings Anandamide concentrations significantly differentiated ASD cases (N = 59) from controls (N = 53), such that children with lower anandamide concentrations were more likely to have ASD (p = 0.041). In keeping with this notion, anandamide concentrations were also significantly lower in ASD compared to control children (p = 0.034). Conclusions These findings are the first empirical human data to translate preclinical rodent findings to confirm a link between plasma anandamide concentrations in children with ASD. Although preliminary, these data suggest that impaired anandamide signaling may be involved in the pathophysiology of ASD.
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Affiliation(s)
- Debra S. Karhson
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
| | - Karolina M. Krasinska
- Vincent Coates Foundation Mass Spectrometry Laboratory, Stanford University, 333 Campus Dr., Stanford, CA 94305 USA
| | - Jamie Ahloy Dallaire
- Department of Comparative Medicine, Stanford University, 287 Campus Dr., Stanford, CA 94305 USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
| | - Allis S. Chien
- Vincent Coates Foundation Mass Spectrometry Laboratory, Stanford University, 333 Campus Dr., Stanford, CA 94305 USA
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
- Department of Comparative Medicine, Stanford University, 287 Campus Dr., Stanford, CA 94305 USA
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Stanford, CA 94305 USA
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Oztan O, Jackson LP, Libove RA, Sumiyoshi RD, Phillips JM, Garner JP, Hardan AY, Parker KJ. Biomarker discovery for disease status and symptom severity in children with autism. Psychoneuroendocrinology 2018; 89:39-45. [PMID: 29309996 PMCID: PMC5878709 DOI: 10.1016/j.psyneuen.2017.12.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 12/20/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by social impairments and repetitive behaviors, and affects 1 in 68 US children. Despite ASD's societal impact, its disease mechanisms remain poorly understood. Recent preclinical ASD biomarker discovery research has implicated the neuropeptides oxytocin (OXT) and arginine vasopressin (AVP), and their receptors, OXTR and AVPR1A, in animal models. Efforts to translate these findings to individuals with ASD have typically involved evaluating single neuropeptide measures as biomarkers of ASD and/or behavioral functioning. Given that ASD is a heterogeneous disorder, and unidimensional ASD biomarker studies have been challenging to reproduce, here we employed a multidimensional neuropeptide biomarker analysis to more powerfully interrogate disease status and symptom severity in a well characterized child cohort comprised of ASD patients and neurotypical controls. These blood-based neuropeptide measures, considered as a whole, correctly predicted disease status for 57 out of 68 (i.e., 84%) participants. Further analysis revealed that a composite measure of OXTR and AVPR1A gene expression was the key driver of group classification, and that children with ASD had lower neuropeptide receptor mRNA levels compared to controls. Lower neuropeptide receptor mRNA levels also predicted greater symptom severity for core ASD features (i.e., social impairments and stereotyped behaviors), but were unrelated to intellectual impairment, an associated feature of ASD. Findings from this research highlight the value of assessing multiple related biological measures, and their relative contributions, in the same study, and suggest that low blood neuropeptide receptor availability may be a promising biomarker of disease presence and symptom severity in ASD.
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Affiliation(s)
- Ozge Oztan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States.
| | - Lisa P. Jackson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
| | - Raena D. Sumiyoshi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305,Department of Comparative Medicine, Stanford University, Stanford, CA 94305
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305
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12
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Abstract
This longitudinal investigation examined the development of emotional and behavioral functioning in school-age children with autism. The Child Behavior Checklist was obtained at baseline and after an average interval of 28.5 months from 13 boys with autism and 14 age- and gender-matched controls between the ages of 7 and 12 years at baseline. Children with autism demonstrated clinically significant elevations in several domains including Social, Thought, and Attention Problems. Children with autism exhibited significant improvements over time in Total, Externalizing, Social, and Oppositional Defiant Problems and Aggressive Behavior, while there were no changes over time in the controls. These findings suggest that children with autism may demonstrate improvements over time in some clinical domains such as social and behavioral functioning.
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Affiliation(s)
- Robin A. Libove
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Thomas W. Frazier
- Center for Autism, Pediatric Institute and Cleveland Clinic Lerner College of Medicine, 2801 Martin Luther King Jr. Drive, Cleveland, OH, 44104, USA
| | - Ruth O’Hara
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
- Corresponding Author: Antonio Y. Hardan, Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA, Tel: +650 723 5511;
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13
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Hardan AY, Gengoux GW, Berquist KL, Libove RA, Ardel CM, Phillips J, Frazier TW, Minjarez MB. A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. J Child Psychol Psychiatry 2015; 56:884-92. [PMID: 25346345 DOI: 10.1111/jcpp.12354] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND With rates of autism diagnosis continuing to rise, there is an urgent need for effective and efficient service delivery models. Pivotal Response Treatment (PRT) is considered an established treatment for autism spectrum disorder (ASD); however, there have been few well-controlled studies with adequate sample size. The aim of this study was to conduct a randomized controlled trial to evaluate PRT parent training group (PRTG) for targeting language deficits in young children with ASD. METHODS Fifty-three children with autism and significant language delay between 2 and 6 years old were randomized to PRTG (N = 27) or psychoeducation group (PEG; N = 26) for 12 weeks. The PRTG taught parents behavioral techniques to facilitate language development. The PEG taught general information about ASD (clinical trial NCT01881750; http://www.clinicaltrials.gov). RESULTS Analysis of child utterances during the structured laboratory observation (primary outcome) indicated that, compared with children in the PEG, children in the PRTG demonstrated greater improvement in frequency of utterances (F(2, 43) = 3.53, p = .038, d = 0.42). Results indicated that parents were able to learn PRT in a group format, as the majority of parents in the PRTG (84%) met fidelity of implementation criteria after 12 weeks. Children also demonstrated greater improvement in adaptive communication skills (Vineland-II) following PRTG and baseline Mullen visual reception scores predicted treatment response to PRTG. CONCLUSIONS This is the first randomized controlled trial of group-delivered PRT and one of the largest experimental investigations of the PRT model to date. The findings suggest that specific instruction in PRT results in greater skill acquisition for both parents and children, especially in functional and adaptive communication skills. Further research in PRT is warranted to replicate the observed results and address other core ASD symptoms.
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Affiliation(s)
- Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Grace W Gengoux
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Kari L Berquist
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Christina M Ardel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Jennifer Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | - Mendy B Minjarez
- Seattle Children's Hospital/Seattle Children's Research Institute, Seattle, WA, USA
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Carson DS, Garner JP, Hyde SA, Libove RA, Berquist SW, Hornbeak KB, Jackson LP, Sumiyoshi RD, Howerton CL, Hannah SL, Partap S, Phillips JM, Hardan AY, Parker KJ. Arginine Vasopressin Is a Blood-Based Biomarker of Social Functioning in Children with Autism. PLoS One 2015; 10:e0132224. [PMID: 26200852 PMCID: PMC4511760 DOI: 10.1371/journal.pone.0132224] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/11/2015] [Indexed: 11/29/2022] Open
Abstract
Brain arginine vasopressin (AVP) critically regulates normative social behavior in mammals, and experimental disruption of the AVP signaling pathway produces social impairments in rodent models. We therefore hypothesized that AVP signaling deficits may contribute to social impairments in children with autism spectrum disorder (ASD). Since blood measures (which are far easier to obtain than brain measures) of AVP are most meaningful if they are related to brain AVP activity, Study 1 tested the relationship between AVP concentrations in concomitantly collected blood and CSF samples from children and adults (N = 28) undergoing clinical procedures. Study 2 tested whether blood AVP concentrations: 1) differed between children with ASD (N = 57), their ASD discordant siblings (N = 47), and neurotypical controls (N = 55); and 2) predicted social functioning (using the NEPSY-II Theory of Mind and Affect Recognition tasks and the Social Responsiveness Scale) in this large, well-characterized child cohort. Blood AVP concentrations significantly and positively predicted CSF AVP concentrations (F1,26 = 7.17, r = 0.46, p = 0.0127) in Study 1. In Study 2, blood AVP concentrations did not differ between groups or by sex, but significantly and positively predicted Theory of Mind performance, specifically in children with ASD, but not in non-ASD children (F1,144 = 5.83, p = 0.017). Blood AVP concentrations can be used: 1) as a surrogate for brain AVP activity in humans; and 2) as a robust biomarker of theory of mind ability in children with ASD. These findings also suggest that AVP biology may be a promising therapeutic target by which to improve social cognition in individuals with ASD.
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Affiliation(s)
- Dean S. Carson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Shellie A. Hyde
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Sean W. Berquist
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Kirsten B. Hornbeak
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Lisa P. Jackson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Raena D. Sumiyoshi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Christopher L. Howerton
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Sadie L. Hannah
- Department of Pediatrics, Division of Pediatric Hematology, Oncology, SCT and Cancer Biology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Sonia Partap
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, 94305, United States of America
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15
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Fung LK, Chahal L, Libove RA, Bivas R, Hardan AY. A retrospective review of the effectiveness of aripiprazole in the treatment of sensory abnormalities in autism. J Child Adolesc Psychopharmacol 2012; 22:245-8. [PMID: 22537360 DOI: 10.1089/cap.2010.0103] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although sensory deficits are frequently observed in autistic individuals, pharmacologic interventions targeting these abnormalities are lacking. The goal of this investigation was to assess the effectiveness of aripiprazole in targeting sensory deficits in children and adolescents with autism. Using an outpatient clinic registry for pervasive developmental disorder, 13 individuals who had received aripiprazole for treating disruptive behaviors and had completed behavioral rating scales (aberrant behavior checklist [ABC] and sensory profile questionnaire [SPQ]) were identified. Mean treatment duration was 24.4 weeks with a mean final aripiprazole dosage of 10.8 mg. Aripiprazole yielded improvements in the total ABC and in several items of the SPQ including registration, inattention/distractibility, auditory processing, and modulation of visual input affecting emotional responses and activity level, suggesting that aripiprazole might be beneficial in targeting sensory abnormalities in autism.
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Affiliation(s)
- Lawrence K Fung
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA.
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