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Calls to Action

Very early behavioral indicators of ASD risk among NICU infants: A prospective study

Staten Island
State/Province Full: 
New York
United States

The aim of this project addresses the Autism Speaks' priority area to develop methods for the very early detection of risk for Autism Spectrum Disorder. Epidemiological studies indicate that ASD is more prevalent when there are complications of pregnancy and delivery. Advances in obstetric and neonatal medicine have resulted in a much higher incidence of multiple gestation infants and an increased survival rate in infants born very small and preterm. These NICU infants are at higher risk for a variety of developmental problems and were recently shown to be at higher risk for ASD. How these risk factors lead to subsequent adverse outcomes such as ASD is not clear. This project addresses this problem by applying the investigators’ theoretical model of neonatal regulatory function likely mediated through brainstem and subcortical control mechanisms that are dependent on CNS development in utero. This is based on retrospective data indicating specific abnormalities at 1 and 4 months adjusted postnatal age in very early behavioral regulation and in developmental transitions of arousal, attention, and visual and motor function in high-medical-risk NICU infants that were associated with later diagnosis of ASD. This study builds on those findings to prospectively identify behavioral patterns that form the basis for a developmental trajectory for ASD risk presumed to link to later ASD diagnoses. This could provide information about potential mechanisms underlying the processes involved that may lead to ASD. The study will also explore factors that impact susceptibility for ASD including medical complications such as preterm birth and brain injury, and environmental factors such as maternal education. Many NICU infants have developmental problems stemming from dysregulation, but most do not reach threshold for specific later ASD diagnoses or have different patterns of early behavioral problems. Identification of specific patterns and trajectories as early indices of ASD risk that can be assessed reliably in infancy will be validated by observational and parent report measures of ASD risk between 18 and 24 months. Thus, findings will contribute to very early detection of ASD risk as well as increased understanding of the mechanisms involved in its development, leading to improved outcome through earlier diagnosis of ASD and intervention for children with autism and their families. [BSRC]