Predicting Autism through Behavioral and Biomarkers of Attention in Infants

了解自闭症的早期预测因素对于促进早期识别、诊断和治疗至关重要。虽然异常的视觉注意力是最早确定的自闭症的预测因子之一，并可能发挥不可或缺的作用，在社会沟通障碍固有的，在婴儿期出现的非典型注意力知之甚少。目前的建议，旨在通过整合认知和发展神经科学的方法，在多组，前瞻性的纵向设计的特点发展异常的注意力在自闭症。方法将包括计算机化的注意力定向和视觉偏好范式与同步测量的心脏定义的持续注意力相结合。整合行为和心脏定义的措施将至关重要地告知行为眼动是否反映了刺激反应的潜在认知过程。行为和生物标志物的模式将在自闭症儿童（ASIBS）的高风险婴儿兄弟姐妹，脆性X综合征（FXS）的高风险婴儿和低风险对照之间进行比较;从而告知早期注意指标的病因特异性，这对于告知早期诊断和治疗工作至关重要。具体而言，我们的目标是：（1）评估注意定向的群体差异（脱离，促进）和视觉偏好（社交/非社交，新奇/熟悉）6、9和12个月大（9和12个月的FXS），（2）比较计算机化注意力范式的行为表现与心脏定义的持续注意力，以及（3）评估24个月时自闭症结果与这些早期行为和注意力生物标志物之间的关系。多层次模型将用于分析高风险人群的注意力模式，以及早期注意力与自闭症结果之间的关系。这项研究是创新的，因为它是第一个同时测量的行为和心脏定义的注意力应用于自闭症婴儿注意力的前瞻性监测，以及比较高风险ASIBS和FXS婴儿的注意力的行为和生物标志物。

Understanding the early predictors of autism is essential to promoting earlier identification, diagnosis and treatment. Although aberrant visual attention is one of the earliest identified predictors of autism and may play an integral role in the socio-communicative deficits inherent in the disorder, the emergence of atypical attention in infancy is poorly understood. The present proposal seeks to characterize the development of aberrant attention in autism by integrating cognitive and developmental neuroscience methods within a multiple-group, prospective longitudinal design. Methods will include computerized attention orienting and visual preference paradigms integrated with concurrently-measured heart-defined sustained attention. Integrating behavioral and heart-defined measures will critically inform whether behavioral eye movement reflects underlying cognitive processes of stimulus response. Patterns of behavioral and biomarkers will be compared across high risk infant siblings of children with autism (ASIBS), high risk infants with fragile X syndrome (FXS), and low risk controls; thus informing the etiological specificity of early attention indicators, which is essential to informing early diagnostic and treatment efforts. Specifically, we aim to: (1) evaluate group differences in attention orienting (disengagement, facilitation) and visual preference (social/nonsocial, novel/familiar) between 6, 9, and 12 months of age (9 and 12 months in FXS), (2) compare behavioral performance on computerized attention paradigms to heart-defined sustained attention, and (3) evaluate the relationship between autistic outcomes at 24 months and these early behavioral and biomarkers of attention. Multilevel modeling will be used to analyze the patterns of attention across high risk groups, as well as the relationship between early attention and autistic outcomes. This study is innovative in that it is the first to apply concurrently-measured behavioral and heart-defined attention to the prospective surveillance of infant attention in autism, as well as to compare behavioral and biomarkers of attention across high risk ASIBS and infants with FXS.