Are early social communication skills a harbinger for language development in infants later diagnosed autistic?—A longitudinal study using a standardized social communication assessment

The early emergence of social communication challenges and their impact on language in infants later diagnosed with autism has sparked many early intervention programs that target social communication skills. While research has consistently shown lower scores on social communication assessments in the first year of life, there is limited research at 12-months exploring associations between different dimensions of social communication and later language. Understanding associations between early social communication skills and language would enhance our ability to choose high priority intervention goals that will impact downstream language skills. The current study used a standardized assessment to profile social communication skills across 516 infants with a high (HL) or low likelihood (LL-Neg) for autism (84% White, 60% Male), based on the presence of a sibling with autism in the family. The primary aim of the study was to profile social communication skill development in the second year of life and to evaluate associations between social communication skills and later language. HL infants who met criteria for autism (HL-ASD, N = 81) demonstrated widespread reductions in social communication skills at 12-months compared to HL infants who did not meet criteria for autism (HL-Neg, N = 277) and LL-Neg (N = 158) infants. Across all infants in the study, those with better social communication skills at 12-months had better language at 24-months. However, within group analyses indicated that infants who met criteria for autism did not show this developmental coupling until 24-months-of-age at which point social communication was positively associated with downstream language skills. The cascading pattern of reduced social communication skills as well as overall significant positive associations with later language provide further evidence for the need to support developing social communication skills prior to formal autism diagnosis, a goal that could possibly be reached through pre-emptive interventions

GPs' decision-making when prescribing medicines for breastfeeding women: Content analysis of a survey

<p>Abstract</p> <p>Background</p> <p>Many breastfeeding women seek medical care from general practitioners (GPs) for various health problems and GPs may consider prescribing medicines in these consultations. Prescribing medicines to a breastfeeding mother may lead to untimely cessation of breastfeeding or a breastfeeding mother may be denied medicines due to the possible risk to her infant, both of which may lead to unwanted consequences. Information on factors governing GPs' decision-making and their views in such situations is limited.</p> <p>Methods</p> <p>GPs providing shared maternity care at the Royal Women's Hospital, Melbourne were surveyed using an anonymous postal survey to determine their knowledge, attitudes and practices on medicines and breastfeeding, in 2007/2008 (n = 640). Content analysis of their response to a question concerning decision-making about the use of medicine for a breastfeeding woman was conducted. A thematic network was constructed with basic, organising and global themes.</p> <p>Results</p> <p>335 (52%) GPs responded to the survey, and 253 (76%) provided information on the last time they had to decide about the use of medicine for a breastfeeding woman. Conditions reported were mastitis (24%), other infections (24%) and depressive disorders (21%). The global theme that emerged was "<it>complexity of managing risk in prescribing for breastfeeding women"</it>. The organising themes were: <it>certainty around decision-making; uncertainty around decision-making; need for drug information to be available, consistent and reliable; joint decision-making; the vulnerable "third party" </it>and <it>infant feeding decision</it>. Decision-making is a spectrum from a straight forward decision, such as treatment of mastitis, to a complicated one requiring multiple inputs and consideration. GPs use more information seeking and collaboration in decision-making when they perceive the problem to be more complex, for example, in postnatal depression.</p> <p>Conclusion</p> <p>GPs feel that prescribing medicines for breastfeeding women is a contentious issue. They manage the risk of prescribing by gathering information and assessing the possible effects on the breastfed infant. Without evidence-based information, they sometimes recommend cessation of breastfeeding unnecessarily.</p

Word Acquisition in Adolescents with Autism Using Video Modeling

Autism is characterized by deficits in communication, which can include deficits in language and vocabulary acquisition. Video modeling has received support as an intervention to teach a variety of skills to children with autism, ranging from vocational and daily living skills to conversational speech and name-writing. This paper presents a brief review of the neural underpinnings of atypical language acquisition, and a novel study testing the effectiveness of a commercially available video modeling system for teaching vocabulary words to four adolescents with low-functioning autism, aged 16-20. The study employs a single case study multiple-baseline across students and multiple-baseline within student across modeling condition design. Results show no advantage of video modeling over in vivo modeling. While receptive mastery was achieved by one student in response to both video and in vivo modeling, no other students showed any receptive learning, and in each showed only modest expressive learning in response to in vivo modeling. In general, video modeling was not an effective technique for word acquisition under these parameters. Potential explanations for the deviation from the literature are discussed, as are limitations and future directions

Language And Brain Development In Autism

Autism Spectrum Condition (ASC) is a highly heritable neurodevelopmental condition, with behavioral symptoms emerging over the first years of life. A full clinical understanding of ASC will require understanding of social-communication behaviors and associated neurobiology, with attention to when ASC-related differences emerge and how they develop over time. Clinicians often cite age 2 as the time when behavioral symptoms are sufficiently crystallized to assign a stable diagnosis of ASC for many children with ASC, but evidence indicates that both brain and behavioral differences emerge much earlier than this. Chapter 1 examines whether the frequency of socially directing vocalizations toward others at 6 and 12 months of age can serve as an early diagnostic marker, finding that it has the potential to predict diagnostic outcomes at age 2. Chapter 2 examines whether rates of canonical babbling differ in 6- and 12-month-old infants later diagnosed with ASC, and whether these differences can be useful early detection markers. Infants later diagnosed with ASC were found to have lower rates of canonical babbling at 12 months. Very little is known about the relationship between early vocalizations (e.g., babbling, crying, laughing) and the developing brain. Chapter 3 investigates the relationship between early vocal behavior and intrinsic functional connectivity in infants 6-24 months old using functional MRI. Vocalizations showed an inconsistent relationship with connectivity between classic language regions, and few relationships with connectivity between brain networks. A large body of work suggests brain structure begins to differ in ASC in this early period, but the exact nature of brain structural differences that persist into childhood and adolescence has been complicated by conflicting findings. Chapter 4 leverages a recently published method for dissociating two regional properties of gray matter – density and volume – to clarify this relationship in a large sample of 6-19 year-olds, finding differences in volume, but not density. Taken together, findings across studies suggest that infant vocalization behaviors have the potential to serve as early diagnostic markers of ASC. These social communication behaviors and the diagnosis of ASC have nuanced relationships with brain structure and function across development

Linguistic markers of autism in girls: evidence of a “blended phenotype” during storytelling

Abstract Background Narrative abilities are linked to social impairment in autism spectrum disorder (ASD), such that reductions in words about cognitive processes (e.g., think, know) are thought to reflect underlying deficits in social cognition, including Theory of Mind. However, research suggests that typically developing (TD) boys and girls tell narratives in sex-specific ways, including differential reliance on cognitive process words. Given that most studies of narration in ASD have been conducted in predominantly male samples, it is possible that prior results showing reduced cognitive processing language in ASD may not generalize to autistic girls. To answer this question, we measured the relative frequency of two kinds of words in stories told by autistic girls and boys: nouns (words that indicate object-oriented storytelling) and cognitive process words (words like think and know that indicate mentalizing or attention to other peoples’ internal states). Methods One hundred two verbally fluent school-aged children [girls with ASD (N = 21) and TD (N = 19), and boys with ASD (N = 41) and TD (N = 21)] were matched on age, IQ, and maternal education. Children told a story from a sequence of pictures, and word frequencies (nouns, cognitive process words) were compared. Results Autistic children of both sexes consistently produced a greater number of nouns than TD controls, indicating object-focused storytelling. There were no sex differences in cognitive process word use in the TD group, but autistic girls produced significantly more cognitive process words than autistic boys, despite comparable autism symptom severity. Thus, autistic girls showed a unique narrative profile that overlapped with autistic boys and typical girls/boys. Noun use correlated significantly with parent reports of social symptom severity in all groups, but cognitive process word use correlated with social ability in boys only. Conclusion This study extends prior research on autistic children’s storytelling by measuring sex differences in the narratives of a relatively large, well-matched sample of children with and without ASD. Importantly, prior research showing that autistic children use fewer cognitive process words is true for boys only, while object-focused language is a sex-neutral linguistic marker of ASD. These findings suggest that sex-sensitive screening and diagnostic methods—preferably using objective metrics like natural language processing—may be helpful for identifying autistic girls, and could guide the development of future personalized treatment strategies

Vocal development in a large‐scale crosslinguistic corpus

This work was supported by two Oswalt Documenting Endangered Languages grants and the Raymond H. Stetson Scholarship in Phonetics and Speech Science to MCy; Agence Nationale de la Recherche (NR-17-CE28-0007 LangAge, ANR-16-DATA-0004 ACLEW, ANR-14-CE30-0003 MechELex, ANR-17-EURE-0017), the James S. McDonnell Foundation Understanding Human Cognition Scholar Award, a Trans-Atlantic Platform "Digging into Data" collaboration grant (ACLEW: Analyzing Child Language Experiences Around The World), with the support of Agence Nationale de la Recherche (ANR-16-DATA-0004) to AC; a Netherlands Organization for Scientific Research Veni Innovational Research Scheme Grant (275-89-033) to MCa; the National Endowment for the Humanities (HJ-253479-17) and NIH Grant DP5-OD019812 to EB; National Science Foundation grants BCS-1529127 and SMA-1539129/1827744 and a James S. McDonnell Foundation Scholar Award to ASW; and by the University of Zurich to CS. The authors do not have any conflicts of interest to report

Data_Sheet_1_Are early social communication skills a harbinger for language development in infants later diagnosed autistic?—A longitudinal study using a standardized social communication assessment.PDF

The early emergence of social communication challenges and their impact on language in infants later diagnosed with autism has sparked many early intervention programs that target social communication skills. While research has consistently shown lower scores on social communication assessments in the first year of life, there is limited research at 12-months exploring associations between different dimensions of social communication and later language. Understanding associations between early social communication skills and language would enhance our ability to choose high priority intervention goals that will impact downstream language skills. The current study used a standardized assessment to profile social communication skills across 516 infants with a high (HL) or low likelihood (LL-Neg) for autism (84% White, 60% Male), based on the presence of a sibling with autism in the family. The primary aim of the study was to profile social communication skill development in the second year of life and to evaluate associations between social communication skills and later language. HL infants who met criteria for autism (HL-ASD, N = 81) demonstrated widespread reductions in social communication skills at 12-months compared to HL infants who did not meet criteria for autism (HL-Neg, N = 277) and LL-Neg (N = 158) infants. Across all infants in the study, those with better social communication skills at 12-months had better language at 24-months. However, within group analyses indicated that infants who met criteria for autism did not show this developmental coupling until 24-months-of-age at which point social communication was positively associated with downstream language skills. The cascading pattern of reduced social communication skills as well as overall significant positive associations with later language provide further evidence for the need to support developing social communication skills prior to formal autism diagnosis, a goal that could possibly be reached through pre-emptive interventions.</p