Enhanced pupillary light reflex in infancy is associated with autism diagnosis in toddlerhood.

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting around 1% of the population. We previously discovered that infant siblings of children with ASD had stronger pupillary light reflexes compared to low-risk infants, a result which contrasts sharply with the weak pupillary light reflex typically seen in both children and adults with ASD. Here, we show that on average the relative constriction of the pupillary light reflex is larger in 9-10-month-old high risk infant siblings who receive an ASD diagnosis at 36 months, compared both to those who do not and to low-risk controls. We also found that the magnitude of the pupillary light reflex in infancy is associated with symptom severity at follow-up. This study indicates an important role of sensory atypicalities in the etiology of ASD, and suggests that pupillometry, if further developed and refined, could facilitate risk assessment in infants

Spotting Signs of Autism in 3-Year-Olds: Comparing Information from Parents and Preschool Staff

© 2018, The Author(s). Preschool informants may provide valuable information about symptoms of autism spectrum disorder (ASD) in young children. We compared the diagnostic accuracy of ratings by preschool staff with those by parents of 3-year-old children using the Achenbach System of Empirically Based Assessment Preschool Forms. The sample consisted of 32 children at familial risk for ASD without diagnosis, 10 children at risk for ASD with diagnosis, and 14 low-risk typically developing controls. Preschool staff ratings were more accurate than parent ratings at differentiating children with and without ASD, and more closely associated with clinician-rated symptoms. These results point to the value of information from preschool informants in early detection and diagnostic assessments

Recognizing Disability and Ability in Young Autistic Children

Autism Spectrum Disorder (ASD) is characterized by impairments, or disabilities, in social communication and interaction (SCI), and restricted and repetitive behaviors (RRBs), but is also associated with enhanced abilities. Early identification of disability in ASD has been a primary focus in clinical practice, while abilities associated with ASD have neither been recognized nor assessed. The overarching purpose of this thesis was to improve early recognition of both disability and ability in young autistic children. Three studies were conducted in a largely overlapping sample of 3-year-old high-risk-for-ASD siblings, either with or without ASD, and low-risk-for-ASD siblings. Study I and II focused on the value of preschool staff as informants in early identification of autistic symptoms, while Study III investigated potential strengths in visual ability in autistic children. Study I investigated how accurately parents and preschool staff rated autistic symptoms in relation to diagnoses and clinical assessment of autistic symptoms. Results showed that ratings by preschool staff were more accurate than parent ratings at differentiating the ASD group from the two other groups, and more closely associated with clinical autistic symptoms. Study II focused on preschool staff’s ratings of social communication and interaction (SCI) and restricted and repetitive behaviors (RRBs). Results showed that ratings of SCI were more accurate than RRBs in differentiating the ASD group from the two other groups, and only the SCI ratings correlated with clinical assessment of social impairment. Study III investigated specific aspects of visual ability with five visual tasks. Similar performance on visual ability was found among groups, except for the Hidden Pictures (HP) task. The children with ASD had superior performance on HP compared with the other two groups. Results of Study I and II suggest that preschool staff report on autistic symptoms may complement parent report in diagnostic assessment of ASD, although their report on RRBs should be interpreted with caution. The results of Study III indicate that enhanced visual ability can be identified in autistic children already at age three. Overall, this thesis suggests that information from preschool staff and assessment of visual ability can contribute to the early recognition of disability and ability in young children with ASD

Differences in Speech Recognition Between Children with Attention Deficits and Typically Developed Children Disappear when Exposed to 65 dB of Auditory Noise

The most common neuropsychiatric condition in the in children is attention deficit hyperactivity disorder (ADHD), affecting approximately 6-9 % of the population. ADHD is distinguished by inattention and hyperactive, impulsive behaviors as well as poor performance in various cognitive tasks often leading to failures at school. Sensory and perceptual dysfunctions have also been noticed. Prior research has mainly focused on limitations in executive functioning where differences are often explained by deficits in pre-frontal cortex activation. Less notice has been given to sensory perception and subcortical functioning in ADHD. Recent research has shown that children with ADHD diagnosis have a deviant auditory brain stem response compared to healthy controls. The aim of the present study was to investigate if the speech recognition threshold differs between attentive and children with ADHD symptoms in two environmental sound conditions, with and without external noise. Previous research has namely shown that children with attention deficits can benefit from white noise exposure during cognitive tasks and here we investigate if noise benefit is present during an auditory perceptual task. For this purpose we used a modified Hagerman’s speech recognition test where children with and without attention deficits performed a binaural speech recognition task to assess the speech recognition threshold in no noise and noise conditions (65 dB). Results showed that the inattentive group displayed a higher speech recognition threshold than typically developed children (TDC) and that the difference in speech recognition threshold disappeared when exposed to noise at supra threshold level. From this we conclude that inattention can partly be explained by sensory perceptual limitations that can possibly be ameliorated through noise exposure

Preschool Staff Spot Social Communication Difficulties, But Not Restricted and Repetitive Behaviors in Young Autistic Children

To fulfill the criteria for autism spectrum disorder (ASD), symptoms must be present across domains and contexts. We assessed preschool staff’s ratings of social communication and interaction (SCI) and restricted and repetitive behaviors (RRBs) in 3-year-old siblings of children with ASD, either diagnosed (n = 12) or not diagnosed (n = 36) with ASD, and typically developing siblings with no family history of ASD (n = 16). Ratings of SCI were more accurate than RRBs in differentiating the ASD group from the two other groups, and only the SCI ratings correlated with SCI symptoms rated by clinical experts. We conclude that while preschool staff ratings of SCI behaviors are adequate, ratings of RRBs should be treated with more caution

- How Does Temperament in Toddlers at Elevated Likelihood for Autism Relate to Symptoms of Autism and ADHD at Three Years of Age?

- The current study investigated longitudinal associations between parent-rated temperament, observed exuberance and accelerometer activity level at 18-months and symptoms of ASD and ADHD at 36-months in a sample of 54 children at elevated likelihood for ASD. For the specific parent-rated temperament scales, most observed significant associations appeared to be specific for either ASD or ADHD symptoms. Indeed, by controlling for overlapping symptoms a different pattern of associations emerged. These results illustrate how temperamental measures may signal risk for later ASD versus ADHD symptomatology in infants at elevated likelihood for ASD. In addition, they indicate the potential of adopting a broader view on neurodevelopmental disorders by investigating not only ASD traits, but also co-occurring disorders such as ADHD in samples of elevated likelihood for ASD

Local and Global Visual Processing in 3-Year-Olds With and Without Autism

© 2018 The Author(s) Research on visual local and global perception in Autism Spectrum Disorder (ASD) is incomplete in young children. We investigated 35 three-year-old siblings of children with ASD, either diagnosed (n = 12) or not diagnosed (n = 23) with ASD as well as 14 controls with typical development and with no family history of ASD. Data from the local tasks Children’s Embedded Figures Test, Hidden Pictures, Figure-Ground and the global tasks Closure and Fragmented Picture Test were collected. Enhanced performance on the local task Hidden Pictures differentiated children with ASD from the other groups. Implications of these results are discussed