EMERGE: Early Markers of Expressive and Receptive (language) Growth in Ethnically diverse autistic toddlers

项目摘要 大多数18-24个月大的自闭症儿童没有语言，这表明他们的语言能力明显延迟。 语言发展，一个主要的关注来源，往往使他们注意到医生或 社区环境中的其他专业人员91，92.这些儿童中约有一半继续表现出显著的 语言延迟，30-33个月时不说话2，语言延迟大于 非语言认知年龄的预期2. 18-30个月的发育期对于 语言学习，与父母注意到孩子的差异的时间段相吻合 发展93.我们不明白为什么有些孩子开始会用词，而有些孩子除了说什么都不会 早期（36个月之前）对发育具有长期和级联效应94，95。这可能是特别 对于低收入，种族和民族多样化的儿童，他们被诊断出来的时间较晚，当被诊断出来时， 通常具有较低的认知/智力能力8。从这样的劣势开始， 儿童，跟踪他们进入专门和隔离的环境，导致整体结果较差。 理解为什么在这个关键的语言学习窗口中，语言结果会出现差异，特别是对于 经济上处于不利地位的儿童和/或历史上处于边缘地位的群体的儿童， 优化早期有效干预的目标和时机。 因此，我们知识中的一个主要差距涉及我们何时可以预测的措施和时间 自闭症幼儿的口语结果，特别是在历史上被边缘化的地区， 少数民族。为了探索语言结果的巨大异质性，有必要 使用一系列并行的口头语言的神经和行为标记， 看看这些变化是如何随着时间的推移而发生的。这项研究将是第一个收集同时社会 沟通，语言，感觉，运动发育和神经活动（通过远程脑电图）的措施，在 家庭谁通常没有从事研究研究，我们将在三个不同的家庭， 在18-30个月的发展窗口期内。参与者包括132名18个月大的幼儿， 自闭症患者在研究开始时表现为没有语言。我们的结果将是新单词的总数， 语言样本这项研究有可能极大地提高我们对语言的理解 在发育迟缓、历史上代表性不足的自闭症幼儿中的增长。它还涉及一个 机构间自闭症协调理事会和NIH的高度优先需求，其中包括重点关注 最低限度的语言，智力残疾儿童和社区样本的历史上被边缘化， 少数民族。

PROJECT ABSTRACT The majority of 18-24-month-old autistic children have no words, demonstrating significant delays in their language development, a leading source of concern that often brings them to the attention of physicians or other professionals in community settings91,92. About half of these children continue to show significant language delay, speaking no words at 30-33 months2 and exhibiting delays in language greater than expected for their nonverbal cognitive age2. The period of development between 18-30 months is critical for language learning, coinciding with the period of time parents note differences in their children’s development93. We do not understand why some children begin to use words and others do not but speaking early (before 36 months) has long-lasting and cascading effects on development94,95. This may be especially true for low income, racially and ethnically diverse children who are diagnosed later, and when diagnosed, often have lower cognitive/intellectual abilities8. Starting out with such disadvantage can limit opportunities for children, tracking them into specialized and segregated settings that result in poorer outcomes overall. Understanding why language outcomes diverge over this critical language learning window, especially for economically disadvantaged children and/or those from historically marginalized groups, is essential to optimize the targets and timing of early, effective interventions. Therefore, a major gap in our knowledge concerns the measures and timing of when we can predict spoken language outcomes of young children with autism, especially in historically marginalized and minoritized populations. To explore the vast heterogeneity in language outcomes, it will be necessary to deeply phenotype children using a range of concurrent neural and behavioral markers of spoken language and examine how these changes progress over time. This study will be the first to collect simultaneous social communication, language, sensory, motor development, and neural activity (via remote EEG) measures in the homes of families who have typically not been engaged in research studies, which we will do at three distinct times over the 18-30-month window of development. Participants include 132 18-month-old toddlers with autism who screen as having no words at study start. Our outcome will be the total number of novel words on a language sample. This study has the potential to dramatically improve our understanding of language growth among developmentally delayed, historically underrepresented, autistic toddlers. It also addresses a high priority need of the Interagency Autism Coordinating Council and NIH, which includes a focus on minimally verbal, intellectually disabled children and community samples of historically marginalized and minoritized populations.