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Babies at risk for autism: Why, how, and what (do we know)?

Babies at risk for autism: Why, how, and what (do we know)?. Mark Johnson. Superior Temporal Sulcus/Gyrus. Left Frontal Operculum. Fusiform Gyrus (blue). Orbitofrontal Cortex (red). How does the social brain develop?. Superior Temporal Sulcus/Gyrus. Left Frontal Operculum.

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Babies at risk for autism: Why, how, and what (do we know)?

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  1. Babies at risk for autism: Why, how, and what (do we know)? Mark Johnson

  2. Superior Temporal Sulcus/Gyrus Left Frontal Operculum Fusiform Gyrus (blue) Orbitofrontal Cortex (red)

  3. How does the social brain develop?

  4. Superior Temporal Sulcus/Gyrus Left Frontal Operculum Fusiform Gyrus (blue) Orbitofrontal Cortex (red)

  5. Infants at-risk for autism

  6. Why? • Research into early onset can get at causal factors • Symptoms may be compounded during development • Possibility of early intervention

  7. Social interaction Communication Restricted behaviors and interests Cause: The triad of impairment

  8. Compounding Symptoms • In developmental disorders, initial symptoms can be compounded by atypical interactions with others and the environment • Important to start early; e.g. over 1,000 hours of face-to-face social interaction in the first year.

  9. Early intervention • Medical research moving to prevention rather than cure • Intervention programmes exist for young children already diagnosed • Can we devise interventions for babies at highest risk, or that show early signs?

  10. How? • How can study the mind/brain of young babies? • What at-risk groups are best for these studies • What design of studies should we use?

  11. How (can we study the mind of babies)?

  12. Behavioral Testing

  13. Looking measures in babies • Preferential looking • Habituation • Eye-tracking

  14. Eye-tracking in babies

  15. EEG/Event-related potentials

  16. ERP Results

  17. Optical imaging (NIRS)

  18. Optical Imaging (NIRS)

  19. Infants at-risk • Children with known genetic conditions (e.g. fragile-X; 30% have ASD) • Children with other known medical conditions (e.g. tuberous sclerosis; 24% have ASD). • Baby brothers and sisters of older children with autism (10%+).

  20. Design of studies • Longitudinal design with infant measures and assessment at 3 years • Involves a 5 year-cycle and hundreds of babies • Currently very few studies have reached this stage

  21. So far…… • Why? Cause, compounding, intervention • How? New methods, study design • What? - do we know so far?

  22. Canadian study(Zwaigenbaum, Bryson and colleagues) • siblings + low-risk controls • Assessed at 6, 12, 18 and 24 months, with diagnostic assessment at 3 years • AOSI: Autism Observation Scale for Infants

  23. AOSI (Bryson et al. In press) • Interactive, play-based measure of early signs of autism • Attention & tracking • Communication (e.g. social babbling) • Social responses (e.g. peek-a-boo) • Play (e.g. imitation) • Motor control

  24. AOSI (examples) Disengagement of visual attentionAnticipation Social babblingImitation

  25. Results so far • No big differences at 6 months - most show typical social behaviours • At 12 months differences appear in several measures (e.g. visual tracking, decreased eye contact, lack of imitation). • By 18 months these differences are much clearer, but still only a 80-90% match with diagnosis at age 3 years

  26. VERY preliminary conclusions • Indicators are present in most children with ASD by 18 months • Key features: early language, social communication, atypical attention and orienting • Developmental trajectories vary: some show regression, others do not • A need for more sensitive measures and methods

  27. Infant Sibs in UK • Collaboration with Tony Charman (ICH), Simon Baron-Cohen (Cambridge), Patrick Bolton (IOP) and others. • Phase 0 (pilot), 31 baby siblings seen at 10 months. Currently seeing them at 3-4 years old. • Phase 1, planned for 100 babies seen at 6, 12, 24 and 36 months

  28. Pilot (Phase 0) study • Parent questionnaires about temperament, medical history etc • Standardised tests (Mullen, Vineland) • Physical growth measurements • Lab measures of attention and perception

  29. Preliminary findings • Baby sibs differ as a group from low-risk controls in subtle measures of attention and social perception • One possible reason - this is due to a few individuals (who may go on to be diagnosed) • Another possibility - sibs do differ as a group, but the vast majority “recover from risk” to develop typically

  30. National Infant Sibs Network • Funded by Autism Speaks (UK) with other charities to start in 2008 • Provides a platform for supporting and encouraging infant sibs work • Central database with shared measures • Meetings, workshops, and training • Mark.johnson@bbk.ac.uk

  31. Centre for Brain & Cognitive Development BabySibs team Holly Garwood Agnes Volein Leslie Tucker Gergely Csibra Mayada Elsabbagh

  32. Thanks to: Collaborators Tony Charman, Patrick Bolton, Simon Baron-Cohen All the babies and their families - Our funders MRC and Autism Speaks

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