Level of Attention to Motherese Speech as an Early Marker of Autism Spectrum Disorder.
Level of Attention to Motherese Speech as an Early Marker of Autism Spectrum Disorder.
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DOI：
10.1001/jamanetworkopen.2022.55125
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发表时间：
2023-02-01
影响因子：
13.8
通讯作者：
Cheng, Amanda
中科院分区：
文献类型：
--
作者：
Pierce, Karen;Wen, Teresa H.;Zahiri, Javad;Andreason, Charlene;Courchesne, Eric;Barnes, Cynthia C.;Lopez, Linda;Arias, Steven J.;Esquivel, Ahtziry;Cheng, Amanda
这项诊断性研究调查了对高情感母亲语的关注是否可以作为12至48个月幼儿自闭症谱系障碍和语言及社交能力的诊断标志。通过眼动追踪索引的对母亲语言的注意力水平是否可以用作自闭症谱系障碍（ASD）的诊断标志，以及它们与社交和语言能力是否相关？在这项对653名12至48个月大的幼儿进行的诊断研究中，没有ASD的幼儿对母亲语言的固定水平很高，但ASD幼儿的固定水平显著降低。如果一个蹒跚学步的孩子对母亲语言的关注度在30%或以下，那么这个孩子被准确识别为ASD的概率为94%，这也意味着与社交和语言能力下降有关。研究结果表明，对母亲语言的关注程度可能是ASD的诊断和预后标志。长期以来，看护者通过用母亲语来吸引婴儿的注意力，这是一种以高度情感为特征的有趣的语言风格。自闭症谱系障碍（ASD）幼儿对母亲语言的关注减少可能是下游语言和社会挑战的一个因素，并可能在诊断上有所揭示。探讨对母亲语的注意是否可以作为ASD的诊断分类器，并与语言和社会能力相关。这项诊断研究包括年龄在12至48个月的幼儿，跨越ASD和非ASD诊断组，在一个研究中心。数据收集时间为2018年2月至2021年4月，分析时间为2021年4月至2022年3月。凝视视情眼动追踪测试。使用凝视视情况眼动追踪，其中幼儿的固定位置触发了一个特定的电影文件，幼儿参加了一个或多个1分钟的眼动追踪测试，旨在量化对母亲语言的注意力，包括母亲语言与交通（即高速公路上嘈杂的车辆）和母亲语言与技术（即音乐的抽象形状）。幼儿也由心理学家进行诊断和心理测量评估。计算了母亲和非母亲电影中的固定水平和每秒的平均扫视次数。受试者工作特征（ROC）曲线用于评估最佳注视截止值以及相关的敏感性、特异性、阳性预测值（PPV）和阴性预测值。在ASD组中，幼儿根据对母亲语言的低、中、高兴趣水平进行分层，并检查与社交和语言能力的关系。共纳入653名幼儿（平均[SD]年龄，26.45 [8.37]个月; 480名男性[73.51%]）。与没有ASD的幼儿不同，在两次测试中，几乎一致地注意到母亲语言的中位数为82.25%和80.75%，在ASD幼儿中，范围很广，从0%到100%。交通和技术范式都是有效的诊断分类器，具有较大的组间效应量（例如，ASD与典型发育：科恩d，技术范式中为1.0）。在这两个范例中，30%或更少的母亲注视的截止值导致ROC曲线下面积（AUC）为0.733（95% CI，0.693-0.773）和0.761（95% CI，0.717-0.804）;特异性分别为98%（95% CI，95%-99%）和96%（95% CI，92%-98%）; PPV为94%（95% CI，86%-98%）。反映了ASD的异质性和预期亚型，敏感性较低，分别为18%（95% CI，14%-22%）和29%（95% CI，24%-34%）。组合指标使AUC增加至0.841（95% CI，0.805-0.877）。自闭症幼儿对母亲语的注意力水平最低，社交和语言能力较弱。在这项诊断性研究中，一部分幼儿对母亲语的注意力水平较低。当使用30%或更低的母亲语固定的截止水平时，在这个范围内的幼儿被诊断为ASD，准确性很高。了解幼儿对母亲的关注程度异常低，不仅有利于ASD的早期诊断和预后，而且可能是一个可能的治疗靶点。
This diagnostic study investigates whether attention to high-affect motherese speech can be used as a diagnostic marker of autism spectrum disorder and language and social ability among toddlers aged 12 to 48 months. Can levels of attention toward motherese speech, indexed through eye tracking, be used as a diagnostic marker of autism spectrum disorder (ASD), and are they associated with social and language abilities? In this diagnostic study of 653 toddlers aged 12 to 48 months, levels of fixation on motherese speech were high in toddlers without ASD but significantly reduced in toddlers with ASD. If a toddler fixated on motherese speech at or below 30%, the probability of that toddler being accurately identified as ASD was 94% and also signified an association with reduced social and language abilities. The findings suggest that levels of attention to motherese speech may be a diagnostic and prognostic marker of ASD. Caregivers have long captured the attention of their infants by speaking in motherese, a playful speech style characterized by heightened affect. Reduced attention to motherese in toddlers with autism spectrum disorder (ASD) may be a contributor to downstream language and social challenges and could be diagnostically revealing. To investigate whether attention toward motherese speech can be used as a diagnostic classifier of ASD and is associated with language and social ability. This diagnostic study included toddlers aged 12 to 48 months, spanning ASD and non-ASD diagnostic groups, at a research center. Data were collected from February 2018 to April 2021 and analyzed from April 2021 to March 2022. Gaze-contingent eye-tracking test. Using gaze-contingent eye tracking wherein the location of a toddler’s fixation triggered a specific movie file, toddlers participated in 1 or more 1-minute eye-tracking tests designed to quantify attention to motherese speech, including motherese vs traffic (ie, noisy vehicles on a highway) and motherese vs techno (ie, abstract shapes with music). Toddlers were also diagnostically and psychometrically evaluated by psychologists. Levels of fixation within motherese and nonmotherese movies and mean number of saccades per second were calculated. Receiver operating characteristic (ROC) curves were used to evaluate optimal fixation cutoff values and associated sensitivity, specificity, positive predictive value (PPV), and negative predictive value. Within the ASD group, toddlers were stratified based on low, middle, or high levels of interest in motherese speech, and associations with social and language abilities were examined. A total of 653 toddlers were included (mean [SD] age, 26.45 [8.37] months; 480 males [73.51%]). Unlike toddlers without ASD, who almost uniformly attended to motherese speech with a median level of 82.25% and 80.75% across the 2 tests, among toddlers with ASD, there was a wide range, spanning 0% to 100%. Both the traffic and techno paradigms were effective diagnostic classifiers, with large between-group effect sizes (eg, ASD vs typical development: Cohen d, 1.0 in the techno paradigm). Across both paradigms, a cutoff value of 30% or less fixation on motherese resulted in an area under the ROC curve (AUC) of 0.733 (95% CI, 0.693-0.773) and 0.761 (95% CI, 0.717-0.804), respectively; specificity of 98% (95% CI, 95%-99%) and 96% (95% CI, 92%-98%), respectively; and PPV of 94% (95% CI, 86%-98%). Reflective of heterogeneity and expected subtypes in ASD, sensitivity was lower at 18% (95% CI, 14%-22%) and 29% (95% CI, 24%-34%), respectively. Combining metrics increased the AUC to 0.841 (95% CI, 0.805-0.877). Toddlers with ASD who showed the lowest levels of attention to motherese speech had weaker social and language abilities. In this diagnostic study, a subset of toddlers showed low levels of attention toward motherese speech. When a cutoff level of 30% or less fixation on motherese speech was used, toddlers in this range were diagnostically classified as having ASD with high accuracy. Insight into which toddlers show unusually low levels of attention to motherese may be beneficial not only for early ASD diagnosis and prognosis but also as a possible therapeutic target.
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DOI：
10.1002/aur.2498
发表时间：
2021-06
期刊：
Autism research : official journal of the International Society for Autism Research
影响因子：
--
作者：
Frazier TW;Coury DL;Sohl K;Wagner KE;Uhlig R;Hicks SD;Middleton FA
通讯作者：
Middleton FA
影响因子：
2.9
作者：
Sulpizio S;Kuroda K;Dalsasso M;Asakawa T;Bornstein MH;Doi H;Esposito G;Shinohara K
通讯作者：
Shinohara K
DOI：
10.1177/1362361318766247
发表时间：
2019-04
期刊：
Autism : the international journal of research and practice
影响因子：
--
作者：
Campbell K;Carpenter KL;Hashemi J;Espinosa S;Marsan S;Borg JS;Chang Z;Qiu Q;Vermeer S;Adler E;Tepper M;Egger HL;Baker JP;Sapiro G;Dawson G
通讯作者：
Dawson G
影响因子：
2.5
作者：
Elison JT;Sasson NJ;Turner-Brown LM;Dichter G;Bodfish JW
通讯作者：
Bodfish JW
DOI：
10.1097/dbp.0000000000000351
发表时间：
2016-10
期刊：
Journal of developmental and behavioral pediatrics : JDBP
影响因子：
--
作者：
Beversdorf DQ;MISSOURI AUTISM SUMMIT CONSORTIUM
通讯作者：
MISSOURI AUTISM SUMMIT CONSORTIUM