Gait and communication growth in typical development and autism spectrum disorder

项目摘要 自闭症谱系障碍(ASD)在美国大约每59名儿童中就有1名受到影响。 一生中巨大的公共卫生负担2。尽管对未来最强有力的预测之一 自闭症患者的独立性是早期的语言能力3，4，潜在的机制被破坏 ASD中的语言发展还没有被很好地理解。最近的研究表明，从 从爬行到行走是语言发展的敏感期，在此期间，患有自闭症的婴儿 表现出非典型的语言发展轨迹。对于典型发育期(TD)的婴儿来说，走路的开始时间很近 与婴儿语言习得率的突然增加有关5-8和婴儿语言习得方式的戏剧性变化 感知他们的环境并与之互动。新出现的证据表明，患有自闭症的婴儿没有表现出 与他们的TD同龄人一样，在步态障碍发作后，语言发展也出现了同样的“突飞猛进”，但原因是 不同之处尚不清楚。我们认为，步态控制，即有效调节和协调 走路所需的有节奏的动作，是支持后续语言发展的基本机制 ASD婴儿出现行走障碍。步态控制不佳可能会阻碍行走后的语言习得 通过使儿童难以获得增加的交际性学习机会而开始 走路的好处包括能看到更多的面孔，还能腾出双手做手势，与人分享物品 已知的支持步态和姿势控制的大脑区域表现出非典型的结构和 ASD患者13、14和年龄较大的ASD儿童和成人的功能表现出较差的步态控制15-17， 这表明ASD患者的步态控制可能从根本上受到干扰。然而，到目前为止，还没有研究表明 前瞻性评估ASD婴儿的早期步态控制。拟议研究的目标是 研究步态控制作为一种潜在的机制，将ASD与语言增长速度的变化联系起来 步行开始。这项研究将测试步行开始后4周是否控制步态(通过压力测量)。 敏感步态垫)可预测高位和高位婴儿开始行走后语言发育速度的变化。 ASD的低家族风险(目标1)。接下来，我们将检查24个月龄的ASD症状是否与 步行开始后进行步态控制(目标2)。最后，拟议的研究还将探讨是否具有创新性 计算机视觉技术可以提供一种婴儿步态评估工具，该工具可更好地扩展到外部环境 该实验室比目前的黄金标准压敏步态垫(目标3)。这项研究将是第一个明确 测试步态控制、语言发展和ASD症状之间的关系。在这样做的过程中，它将屈服 更深入地了解早期运动和语言发展之间的联系 期间，有可能确定早期干预的可能目标，以促进语言水平的提高 ASD婴儿的结局。综上所述，该项目和随附的培训计划将为 申请从事研究ASD早期运动和社交发展的职业。

Project Summary Autism spectrum disorder (ASD) affects approximately 1 in 59 children in the United States1 and incurs substantial public health burden over the lifespan2. Although one of the strongest predictors of later independence for individuals with ASD is early language ability3,4, the mechanisms underlying disrupted language development in ASD are not well understood. Recent research indicates that the transition from crawling to walking represents a sensitive period for language development, during which infants with ASD exhibit atypical trajectories of language growth. For typically-developing (TD) infants, walk onset is closely linked with a sudden increase in infants’ rate of language acquisition5–8 and dramatic changes in how infants perceive and interact with their environment. Emerging evidence indicates that infants with ASD do not exhibit the same “spurt” in language development following walk onset as their TD peers5, but reasons for this difference are not yet known. We propose that gait control, the ability to effectively regulate and coordinate the rhythmic movements needed for walking, is a fundamental mechanism supporting language growth following walk onset that is impaired in infants with ASD. Poor gait control may impede language acquisition after walk onset by making it difficult for children to access the increased communicative learning opportunities that walking affords, including seeing more faces9 and having hands free to gesture10 and share objects with others11,12. Regions of the brain known to support gait and postural control exhibit atypical structure and function in individuals with ASD13,14, and older children and adults with ASD exhibit poorer gait control15–17, indicating that gait control may be fundamentally disrupted in ASD. However, no studies to date have prospectively assessed early gait control in infants with ASD. The goal of the proposed research is to investigate gait control as a potential mechanism linking ASD to change in the rate of language growth after walk onset. This study will test whether gait control 4 weeks after walk onset (measured by a pressure- sensitive gait mat) predicts change in the rate of language growth following walk onset in infants at high and low familial risk for ASD (Aim 1). Next, we will examine whether ASD symptoms at 24 months are associated with gait control after walk onset (Aim 2). Finally, the proposed study will also explore whether innovative computer vision technology can provide an infant gait assessment tool that is more scalable to settings outside the lab than current gold-standard pressure-sensitive gait mats (Aim 3). This study will be the first to explicitly test the relationships between gait control, language development, and ASD symptoms. In so doing, it will yield a deeper understanding of the link between early motor and language development during this sensitive period, with the potential to identify possible targets for early intervention to promote improved language outcomes in infants with ASD. Taken together, this project and the accompanying training plan will prepare the applicant for a research career investigating the early motor and social communication development in ASD.