Developmental pathways to autism: a review of prospective studies of infants at risk.

Developmental pathways to autism: a review of prospective studies of infants at risk.
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DOI:
10.1016/j.neubiorev.2013.12.001
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发表时间:
2014-02
影响因子:
8.2
通讯作者:
Johnson, Mark H.
Johnson, Mark H.
中科院分区:
医学1区
文献类型:
--
作者:
Jones, Emily J. H.;Gliga, Teodora;Bedford, Rachael;Charman, Tony;Johnson, Mark H.

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对有家族风险的婴儿进行的前瞻性研究正在描绘自闭症谱系障碍(ASD)的发育途径。患有自闭症谱系障碍的儿童在第二年会表现出社交和沟通困难。早期的神经认知标志包括对凝视的非典型神经反应和缓慢的脱离。绘制自闭症谱系障碍从出生起的发展过程对于早期识别和干预至关重要。自闭症谱系障碍 (ASD) 是一种神经发育障碍,其特征是社交互动和沟通障碍,以及存在限制性和重复性行为。自闭症谱系障碍的症状可能是由于先前存在的神经发育脆弱性与儿童环境之间复杂的相互作用而产生的,并受到补偿技能和保护因素的影响。对自闭症谱系障碍高家族风险婴儿(有一个患有自闭症谱系障碍的哥哥姐姐)的前瞻性研究开始描述这些临床症状出现的发育途径。在这里,我们回顾了在生命最初几年的高危婴儿中发现的后期自闭症谱系障碍的行为和神经认知标志物的范围。我们讨论新兴模式的理论含义,并确定未来工作的关键方向,包括该领域几个方法论挑战的潜在解决方案。绘制自闭症谱系障碍从出生起的发展过程对于我们理解这种疾病的发育机制至关重要。对自闭症谱系障碍的发展途径有更细致的了解不仅有助于我们识别需要早期干预的儿童,而且还能改善他们可用的干预措施的范围。
Prospective studies of infants at familial risk are characterizing developmental pathways to ASD. Children with ASD show social and communication difficulties in the second year of life. Early neurocognitive markers include atypical neural response to gaze and slowed disengagement. Mapping how ASD unfolds from birth is central to early identification and intervention. Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders characterized by impairments in social interaction and communication, and the presence of restrictive and repetitive behaviors. Symptoms of ASD likely emerge from a complex interaction between pre-existing neurodevelopmental vulnerabilities and the child's environment, modified by compensatory skills and protective factors. Prospective studies of infants at high familial risk for ASD (who have an older sibling with a diagnosis) are beginning to characterize these developmental pathways to the emergence of clinical symptoms. Here, we review the range of behavioral and neurocognitive markers for later ASD that have been identified in high-risk infants in the first years of life. We discuss theoretical implications of emerging patterns, and identify key directions for future work, including potential resolutions to several methodological challenges for the field. Mapping how ASD unfolds from birth is critical to our understanding of the developmental mechanisms underlying this disorder. A more nuanced understanding of developmental pathways to ASD will help us not only to identify children who need early intervention, but also to improve the range of interventions available to them.
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