Early Identification of Autism: A Prospective Study

自闭症的早期识别：一项前瞻性研究

• 批准号: 7799819
• 负责人: Jana M Iverson
• 金额: $ 51.95万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7799819
• 关键词: 2 year old; 3 year old; Age; Attention; Audiotape; Autistic Disorder; Behavior; Behavioral; Child; Clinical; DSM-IV; Data; Development; Diagnosis; Diagnostic; Disease; Early identification; Equipment and supply inventories; Exhibits; Face; Family history of; Frequencies; Funding; Gestures; Goals; Grant; Home environment; Impairment; Infant; Infant Development; Intervention; Judgment; Language Delays; Lead; Literature; Logic; Longitudinal Studies; Mental disorders; Methods; Motor; Motor Skills; Movement; Musculoskeletal Equilibrium; Nature; Outcome; Parents; Participant; Pattern; Population; Predictive Value; Production; Prospective Studies; Recurrence; Relative (related person); Reporting; Research; Research Design; Risk; Risk Marker; Sampling; Schedule; Sensitivity and Specificity; Siblings; Subgroup; Techniques; Terminology; Testing; Theoretical model; Time; Upper Extremity; Variant; Videotape; Visit; Work; autism spectrum disorder; design; falls; follow-up; improved; indexing; infancy; instrument; joint attention; limb movement; oral motor; pediatrician; prospective; research and development; skills; social; success; tool; vocalization

DESCRIPTION (provided by applicant): Early initiation of intensive intervention may lead to improved outcomes for children with autism spectrum disorders (ASD); yet there are currently no reliable techniques for diagnosing ASD before the age of two years. This research is designed to identify variations in frequencies of occurrence, delayed onset, and/or atypicalities in vocal, motor, and communicative skills that may index later ASD diagnosis. The approach taken involves describing the development of these skills in infant siblings of older children who have been diagnosed with Autism. Infant Siblings are known to be at elevated risk for ASD and language delay. The goal will be to distinguish prospectively between those Infant Siblings eventually diagnosed with ASD, those eventually diagnosed with Language Delay but not ASD, and those with no apparent atypicalities. One hundred fifty Infant Siblings will be observed longitudinally from ages 5 to 14 months, with follow-up at 18, 24, and 36 months. Audio- and videotaped observations designed to sample behavior in contexts that are consistent across participants, standardized instruments, and parental reports will be employed to study vocalizations, rhythmic limb movements, vocal-motor coordinations, postural and locomotor abilities, gross, fine, and oral-motor skills, words, and gestures. Diagnostic outcomes will be assessed at 36 months with the Autism Diagnostic Observation Schedule, Autism Diagnostic Inventory-Revised, and clinical judgment using DSM-IV criteria. Data from all three subgroups of Infant Siblings will also be compared to parallel data from infants with no known risk for ASD currently being followed as part of separate NAAR and NIH-funded studies. Analyses will focus on identifying behavioral markers in infancy that predict a later diagnosis of ASD, assessing their positive predictive value, sensitivity, and specificity, and on evaluating a set of hypotheses concerning variation in patterns of production and developmental trajectories of infant vocal, motor, and communicative behaviors that may differentiate groups and predict an eventual ASD or Language Delay diagnosis. We currently lack reliable methods for diagnosing autism spectrum disorders (ASD) in children younger than 2 years of age. To identify possible predictors of later ASD diagnosis, this study will focus on the development of vocal, motor, and communicative skills in infants at particular risk for ASD and relate atypicalities in infant development to diagnostic status at 3 years of age.

描述（由申请人提供）：早期开始强化干预可能会改善自闭症谱系障碍（ASD）儿童的预后；然而，目前还没有可靠的技术可以在两岁之前诊断自闭症谱系障碍。这项研究旨在识别发生频率的变化、延迟发作和/或声音、运动和交流技能的非典型性，这些可能为以后的自闭症谱系障碍诊断提供依据。所采取的方法包括描述被诊断患有自闭症的大孩子的婴儿兄弟姐妹的这些技能的发展情况。众所周知，婴儿兄弟姐妹患自闭症谱系障碍和语言发育迟缓的风险较高。目标是前瞻性地区分最终诊断为自闭症谱系障碍的婴儿兄弟姐妹、最终诊断为语言迟缓但非自闭症谱系障碍的婴儿兄弟姐妹以及没有明显异常现象的婴儿兄弟姐妹。将对 150 名 5 至 14 个月的婴儿兄弟姐妹进行纵向观察，并在 18、24 和 36 个月时进行随访。录音和录像观察旨在对参与者一致的环境中的行为进行采样，标准化仪器和家长报告将用于研究发声、有节奏的肢体运动、发声运动协调、姿势和运动能力、粗大、精细和口腔运动技能、单词和手势。诊断结果将在 36 个月时使用自闭症诊断观察计划、自闭症诊断清单修订版和使用 DSM-IV 标准的临床判断进行评估。来自婴儿兄弟姐妹所有三个亚组的数据也将与目前作为 NAAR 和 NIH 资助的单独研究的一部分进行跟踪的、没有已知自闭症谱系障碍风险的婴儿的平行数据进行比较。分析将侧重于识别婴儿期可预测 ASD 诊断的行为标志物，评估其阳性预测值、敏感性和特异性，并评估一组有关婴儿发声、运动和交流行为的生产模式和发育轨迹变化的假设，这些假设可区分群体并预测最终的 ASD 或语言发育迟缓诊断。我们目前缺乏诊断 2 岁以下儿童自闭症谱系障碍 (ASD) 的可靠方法。为了确定以后 ASD 诊断的可能预测因素，本研究将重点关注具有 ASD 特定风险的婴儿的声音、运动和沟通技能的发展，并将婴儿发育的非典型性与 3 岁时的诊断状态联系起来。