Sensor-based technology in the study of motor skills in infants at risk for ASD

描述（由申请人提供）：虽然社交障碍被认为是自闭症谱系障碍（ASD）的主要障碍，但最近的证据表明，运动障碍也是ASD行为特征的重要组成部分。对婴儿期ASD行为标志物识别的兴趣最近导致了一些对已知ASD和其他发育迟缓风险升高的婴儿（高危婴儿; HR）的前瞻性纵向研究。尽管越来越多的文献对运动的关注，在ASD，相对较少的关注一直致力于运动技能的HR婴儿的早期发展。此外，HR婴儿在3岁时的结果存在广泛的变异性，运动能力的变异可能与其他领域（例如社交、语言）的发育结果的个体差异有关。本研究的目的是检查精细运动和物体操作技能的HR和比较婴儿没有这样的风险（低风险婴儿; LR）之间的12个月和36个月。所采取的方法是创新的，因为它涉及到新开发的，技术先进的传感器技术的应用，设计用于在非结构化的设置结合纵向行为观察收集精细的详细信息的组织和质量的儿童的运动，因为他们执行三个运动任务的难度不同。通过标准化运动评估的补充，这些数据将支持精细运动和物体操作能力的分析，比迄今为止可能的方式更加微妙和复杂。作为一项更大研究的一部分，已经对20名HR婴儿进行了5至36个月的随访，并将在12、14、18、24和36个月时在家中观察20名LR婴儿，因为他们执行运动任务，包括伸手、运输和将物体放置在目标位置。另外一个由50名儿童组成的跨部门小组也将参加，每个年龄10名。运动数据将通过嵌入物体中的轻量级传感器腕带和传感器收集。分析将集中在整体风险组的差异，在运动学和行为变量的变化作为任务难度和年龄的函数，并在不同年龄组的困难的相互作用。这些将用于评估HR儿童的运动技能的发展轨迹和可能的发展延迟和损伤，检查运动技能和HR儿童在其他发展领域中表现出的延迟之间的关系，并提供有关可能与ASD的最终诊断相关的运动学和行为特征的初步信息。 公共卫生相关性：最近自闭症谱系障碍的诊断迅速增加，这使得我们必须更多地了解ASD高危儿童的早期发育。由于运动障碍在患有ASD的大龄儿童中很常见，并且由于有ASD风险的婴儿通常表现出早期运动延迟，因此该研究将重点关注有风险婴儿的运动技能的早期发展，并将这些信息与后来的发育结果联系起来。为了做到这一点，一种新的运动测量技术将与风险和比较低风险儿童的详细行为观察一起使用，因为他们在12至36个月之间从事一系列自然运动任务。

DESCRIPTION (provided by applicant): Although deficits in social communication are considered primary in autism spectrum disorders (ASD), recent evidence suggests that motor impairments also constitute a prominent component of the ASD behavioral profile. Interest in the identification of behavioral markers of ASD in infancy has recently led to a number of prospective, longitudinal studies of infants known to be at elevated risk for ASD and other developmental delays (High-Risk infants; HR). Despite the growing literature on motor concerns in ASD, relatively little attention has been devoted to the early development of motor skills in HR infants. In addition, there is wide variability in the outcomes of HR infants at age 3, and it is possible that variation in motor ability may be related to individual differences in developmental outcomes in other domains (e.g. social communication, language). This research is designed to examine fine motor and object manipulation skills in HR and comparison infants with no such risk (Low Risk infants; LR) between the ages of 12 and 36 months. The approach taken is innovative because it involves the application of newly-developed, technologically sophisticated sensor technology designed for use in unstructured settings in combination with longitudinal behavioral observation to collect finely detailed information about the organization and quality of children's movements as they perform three motor tasks at varying levels of difficulty. Supplemented by standardized motor assessments, these data will support the analysis of fine motor and object manipulation abilities in a much more subtle and sophisticated fashion than has heretofore been possible. Twenty HR infants already being followed from 5 to 36 months as part of a larger study and 20 LR infants will be observed at home at ages 12, 14, 18, 24, and 36 months as they perform motor tasks that involve reaching for, transporting, and placing an object at a target location. An additional cross-sectional group of 50 children, 10 at each age listed above, will also participate. Kinematic data will be collected via lightweight sensorized wristbands and sensors embedded in the objects. Analyses will focus on overall risk group differences, on change in the kinematic and behavioral variables as a function of task difficulty and age, and on group by difficulty interactions at varying ages. These will be used to evaluate developmental trajectories and possible developmental delays and impairments in the motor skill of HR children, to examine the relation between motor skills and delays exhibited by HR children in other developmental domains, and to provide preliminary information about kinematic and behavioral signatures that may be related to an eventual diagnosis of ASD. PUBLIC HEALTH RELEVANCE: The recent rapid increase in diagnosis of Autism Spectrum Disorders makes it imperative that we learn more about the early development of children at high risk for ASD. Because motor impairments are common in older children with ASD, and because infants at risk for ASD often exhibit early motor delays, the research will focus on the early development of motor skills in at-risk infants and relate this information to later developmental outcomes. To do this, a novel movement measurement technology will be employed together with detailed behavioral observations of at-risk and comparison low-risk children as they engage in a series of naturalistic motor tasks between the ages of 12 and 36 months.