Pre- and Postnatal Neurobehavioral Profiles in Infants at Risk for Autism

描述(由申请者提供)：确定自闭症的早期症状是研究的关键目标。这项研究将检查患有自闭症谱系障碍(ASD)大孩子的母亲的胎儿，以确定产前和新生儿期自闭症的迹象。ASD是高度可遗传的，兄弟姐妹患自闭症的风险增加。最近对高危婴儿(那些有患有自闭症的哥哥姐姐的婴儿)的研究发现，在婴儿早期就可能出现自闭症的迹象。这些风险迹象包括已知的指示ASD后期发展的行为特征，包括较差的社会注意力、社会责任感和眼神接触。来自典型人群和其他非典型人群的研究支持了对胎儿时期生物行为反应特征的可靠测量。因此，有证据表明，有可能在围产期和出生后早期识别自闭症的迹象。这些发现将对理解自闭症的发展过程产生深远的影响，并将为在发展的最早阶段进行识别和治疗打开大门。我们将调查患有自闭症(高危胎儿)的大龄孩子的孕妇与有典型发育(低危胎儿)的大龄孩子的母亲相比，胎儿的运动和心率对社会和非社会刺激的反应。研究表明，胎儿对刺激的反应预示着以后的行为和气质，胎儿可以辨别熟悉的声音(即对社会刺激的不同反应)。基于这些发现，并利用我们实验室中已经使用的程序，我们将对胎儿实施振动声刺激(振动加声音；在产前产科护理中经常使用)和一系列社会刺激(母亲和陌生人的声音的录音)。我们将通过观察运动、心率和其他反应性迹象的变化来测量胎儿的反应。新生儿行为和反应性的测量将在新生儿期进行，包括类似于妊娠晚期的刺激，新生儿神经行为检查，以及声学哭声分析。我们对结果数据的初步检查将是比较高风险婴儿和低风险婴儿的反应情况。该项目将为高危婴儿的发育跟踪奠定基础，并将为更广泛的此类研究提供先导数据。公共卫生相关性：这项研究对自闭症儿童的早期识别和干预都具有高度相关性。通过确定有自闭症风险的婴儿在胎儿和新生儿时期的非典型行为和反应模式，这项研究将有助于开发更敏感和具体的筛查和诊断工具，供婴儿使用。此外，这项研究将提高我们对自闭症损害的根源和过程的理解。

DESCRIPTION (provided by applicant): Identification of early signs of autism is a critical goal for research. This study will examine fetuses of mothers who have older children with autism spectrum disorder (ASD) in order to identify signs of autism in the prenatal and newborn periods. ASD is highly heritable and there is elevated risk for autism in siblings. Recent research on high-risk infants (those with an older sibling with ASD) has identified potential signs of autism by early infancy. These signs of risk include behavioral features known to be indicative of ASD in later development, including poor social attention, social responsivity, and eye contact. Research from typical and other atypical populations supports the reliable measurement of biobehavioral response profiles in the fetal period. Thus, evidence indicates that it may be possible to identify signs of autism the perinatal and early postnatal periods. Such findings would have profound implications for understanding the developmental course in ASD and would open the door to both identification and treatment in the earliest stages of development. We will investigate fetal movement and heart rate in response to social and non-social stimuli in pregnant mothers who have an older child with an ASD (high risk fetuses) as compared to mothers who have older children with typical development (low risk fetuses). Research has demonstrated that fetal responses to stimuli are predictive of later behavior and temperament, and that fetuses can discriminate familiar voices (i.e., respond differentially to social stimuli). Based on these findings, and utilizing procedures already used in our lab, we will administer vibroacoustic stimulus (vibration plus sound; used regularly in prenatal obstetric care) and a series of social stimuli to the fetus (audio recording of the mother's and a stranger's voice). We will measure fetal responses by observing changes in movement, heart rate, and other signs of reactivity. Measures of neonatal behavior and reactivity will be administered in the newborn period, including analogues to the 3rd trimester stimuli, a newborn neurobehavioral exam, and acoustic cry analyses. Our initial examination of the resulting data will be to compare the response profiles of high and low risk infants. This project will lay the groundwork for developmental follow-up of the at risk infants, and will provide pilot data to support a more extensive study of this kind. PUBLIC HEALTH RELEVANCE: This research is highly relevant to both early identification and intervention for children with autism. By identifying atypical behavioral and reactivity patterns in the fetal and newborn periods in infants at risk for autism, this research will aide in the development of more sensitive and specific screening and diagnostic tools for use in infancy. In addition, this research will improve our understanding of the roots and course of impairments in autism.