Sensory Project in Infant/Toddler Siblings of Children with Autism (Project SPIS)

摘要 自闭症患者在发展语言方面遇到挑战，这些挑战影响他们的长期社交， 学术和职业成功。以前的研究已经确定了几个预测儿童语言的因素 但是，即使考虑到这些预测因素，语言的大量差异 仍然无法解释重要的是，许多自闭症儿童仍然没有发展出“有用的言语”或语言 能力，尽管接受针对这些先前确定的预测因素的干预。因此，有一个 迫切需要确定自闭症儿童语言的新预测因素。 有人提出，感觉反应的差异可能在生命早期出现， 大脑状态和影响孩子与周围环境中的其他人交往的能力，从而产生 自闭症儿童语言习得的“级联效应”如果是这样的话， 早期的感觉反应可能会通过影响大脑状态， 提高这一人群的参与度。虽然直觉上很吸引人，但考虑到我们对 优先和可能的“基础”性质的早期感觉发展相对于出现 由于语言技能的“高层次”，级联效应理论的证据至今还相当有限。 建立上述联系的一个主要挑战是自闭症并不总是可靠的。 在生命的最早阶段被诊断（即，在婴儿期和幼儿期）。一个潜在的解决方案是前瞻性地 跟踪已知未来极有可能被诊断为自闭症和语言障碍的婴儿和幼儿， disorder.自闭症儿童的婴儿/幼儿睡眠中的感觉项目（SPIS项目） 先前NIDCD资助的R21（R21 DC 016144; PI：Woynaroski）在级联效应的综合测试中， 在自闭症儿童的婴儿和幼儿兄弟姐妹（Sibs-AUT）中，大约三分之一的人 会继续被诊断为自闭症或语言障碍，而婴儿在相对较低的一般人群中， 这些条件的水平可能性（典型发育儿童的弟弟妹妹;同胞TD）。 新奇和影响：这个创新和跨学科的项目预计将进一步阐明 一个潜在的易处理的，但相对研究不足的因素（早期感觉）之间的纵向联系的性质 反应）和语言在婴儿中的升高和降低，一般人群水平的自闭症可能性。如果 当我们的假设被证实时，这项研究的结果将为临床试验奠定基础， 有针对性地治疗感觉功能对语言远端效应的疗效， 近端效应对静息脑状态和参与婴儿在自闭症的高可能性。这项工作是 预计将有助于早期识别语言障碍，并指出新的目标， “预防性”干预措施，从而改善被诊断患有 患自闭症和语言障碍的风险更高。

Abstract Individuals with autism experience challenges in developing language that impact their long-term social, academic, and vocational success. Previous research has identified several predictors of language in children with autism, but even when these predictors are considered, a large amount of the variance in language remains unexplained. Importantly, many children with autism still do not develop “useful speech” or language ability, despite receiving interventions that target these previously-identified predictors. Thus, there is a pressing need to identify novel predictors of language in children with autism. It has been proposed that differences in sensory responsiveness may emerge early in life from altered brain states and impact a child's ability to engage with others in their environment, thereby producing “cascading effects” on language acquisition in children affected by autism. If this is the case, intervening upon early sensory responsiveness may translate to improved language outcomes, by influencing brain states and boosting engagement in this population. Although intuitively appealing, given our understanding of the precedence and possible “foundational” nature of early sensory development relative to the emergence of “higher-level” language skill, evidence for the cascading effects theory to date has been rather limited. A primary challenge to establishing the aforementioned links is that autism cannot always be reliably diagnosed in the earliest stages of life (i.e., in infancy and toddlerhood). A potential solution is to prospectively follow infants and toddlers known to be at high likelihood for a future diagnosis of autism and language disorder. The Sensory Project in Infant/Toddler Siblings of Children with Autism (Project SPIS) scales up a prior NIDCD-funded R21 (R21DC016144; PI: Woynaroski) in a comprehensive test of the cascading effects framework in infant and toddler siblings of children with autism (Sibs-AUT), approximately one-third of whom will go on to be diagnosed with autism or language disorder, and infants at relatively lower, general population- level likelihood of these conditions (younger siblings of typically developing children; Sibs-TD). NOVELTY AND IMPACT: This innovative and interdisciplinary project is expected to further elucidate the nature of longitudinal links between a potentially tractable, but relatively understudied factor (early sensory responsiveness) and language in infants at elevated and lower, general population-level likelihood of autism. If our hypotheses are born out, findings of the study will lay the foundation for a clinical trial that will examine the efficacy of a targeted treatment of sensory function for distal effects on language as mediated by more proximal effects on resting brain states and engagement in infants at high likelihood for autism. This work is expected to facilitate earlier identification of language impairments and point towards novel targets of early “preventative” interventions, thereby improving the long-term outcomes of children who are diagnosed with, or at heightened risk for, autism and language disorder.