Performance Indices of Social Disability in Toddlers with Autism

描述(由申请人提供)： /摘要本项目--“自闭症儿童社会残疾表现指数”--涉及挑战领域“(04)临床研究”和具体挑战主题“自闭症：应对挑战(04-MH-101*)”；挑战领域“(01)行为、行为改变和预防”以及具体挑战主题“基于个人的社会行为模式(01-GM-101*)”。这个项目的总体目标是开发社会投入的绩效指数，可以在最早诊断时使用这些指数来分析症状表现的异质性，并确定结果的预测因素。我们将收集眼球跟踪数据，以量化在观看N=80名12至24个月大的患有自闭症谱系障碍(ASD)、非自闭症发育迟缓和典型发育的婴儿的自然社交情况时的视觉注视和扫描。实验时儿童广泛的临床特征将得到耶鲁ACE的支持，该计划还将支持36至48个月大的儿童获得诊断确认和发育评估程序，这超出了本RC1的范围。基于一项5分钟的行为测试，我们将得出(1)眨眼抑制作为刺激显著指数；(2)注意力转移作为适应性社交视觉追求指数；(3)社会视觉监控作为积极追求交流意图的指数。支持使用这三种方法的工作涉及2至3岁的儿童、学龄儿童和患有自闭症的青少年。在这一应用中，我们将我们的方法扩展到研究生命第二年的社会参与。这款应用建立在7年来的开创性工作基础上，利用眼球跟踪技术来测量420多名ASD患者从婴儿期到青春期(U54-MH66494，P50 MH081756和R01 MH083727，Pi A Klin)在观看自然社交场合时的自发视觉注视和视觉扫描。我们的具体目标直接针对国立卫生研究院机构间自闭症协调委员会的三个主要主题：“自闭症谱系障碍的异质性”、“结果的预测因素”和“生物标记物”。自闭症患者表现出的能力和症状的巨大差异是研究其原因和治疗的最大挑战之一。使用眼球跟踪技术，该项目采用了三种新的和融合的社会参与表现衡量标准，以量化一组12至24个月大的自闭症谱系障碍婴儿的社会残疾，并评估其临床应用价值。这些措施是从一段简短的5分钟商业视频中得出的，该视频描绘了正在玩耍的幼儿。这项工作的目标是量化自闭症在最早发现期间的核心和定义症状。

DESCRIPTION (provided by applicant): / Abstract This project - 'Performance Indices of Social Disability in Toddlers with Autism' - addresses Challenge Area '(04) Clinical Research' and Specific Challenge Topic 'Autism: Addressing the Challenge (04-MH-101*)'; and Challenge Area '(01) Behavior, Behavioral Change, and Prevention' and Specific Challenge Topic 'Individual- Based Model of Social Behavior (01-GM-101*)'. The overarching goal of this project is to develop performance indices of social engagement which can be used at the earliest point of diagnosis to parse out heterogeneity of syndrome expression and identify predictors of outcome. We will collect eye-tracking data to quantify visual fixation and scanning during viewing of naturalistic social situations in N=80 12- to 24-month-old infants with autism spectrum disorders (ASD), non-autistic developmental delays, and typical development. The children's extensive clinical characterization at the time of the experiments will be supported by the Yale ACE, which will also support diagnostic confirmation and developmental assessment procedures to be obtained at ages 36 to 48 months, which is beyond the scope of this RC1. Based on a single, 5-minute behavioral assay, we will derive measures of (1) eye-blink inhibition as an index of stimulus salience; (2) attention shifting as an index of adaptive, social visual pursuit; and (3) social visual monitoring as an index of active pursuit of communicative intentions. Work supporting the utility of these three methods has involved 2- to 3-year-olds, school-age children, and adolescents with ASD. In this application, we extend our methods to the study of social engagement in the second year of life. This application builds on 7 years of pioneering work capitalizing on eye-tracking technology to measure spontaneous visual fixations and visual scanning during viewing of naturalistic social situations in over 420 individuals with ASD, from infancy through adolescence (U54- MH66494, P50 MH081756, and R01 MH083727, PI A Klin). Our specific aims address directly three major themes in the National Institutes of Health Interagency Autism Coordinating Committee: 'Heterogeneity of Autism Spectrum Disorders', 'Predictors of Outcome' and 'Biomarkers'. The vast variability of abilities and symptoms displayed by individuals with autism is one of the greatest challenges for research on its causes and treatment. Using eye-tracking technology, this project employs three novel and converging performance measures of social engagement to quantify social disability in a group of 12- to 24-month old infants with autism spectrum disorders and to assess their clinical utility. These measures are derived from one brief, 5-minute viewing of a commercial video portraying toddlers at play. The goal of this work is to quantify a core and defining symptom of autism during the period of earliest detection.