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      The development of face orienting mechanisms in infants at-risk for autism

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          ► Infants preferentially orient to socially relevant information such as faces. ► Infants at-risk for autism have a tendency to sustain attention to faces. ► Those infants who later develop autism show an equally strong face orienting response. ► Combined influence of social and attentional brain systems is implicated in autism.


          A popular idea related to early brain development in autism is that a lack of attention to, or interest in, social stimuli early in life interferes with the emergence of social brain networks mediating the typical development of socio-communicative skills. Compelling as it is, this developmental account has proved difficult to verify empirically because autism is typically diagnosed in toddlerhood, after this process of brain specialization is well underway. Using a prospective study, we directly tested the integrity of social orienting mechanisms in infants at-risk for autism by virtue of having an older diagnosed sibling. Contrary to previous accounts, infants who later develop autism exhibit a clear orienting response to faces that are embedded within an array of distractors. Nevertheless, infants at-risk for autism as a group, and irrespective of their subsequent outcomes, had a greater tendency to select and sustain attention to faces. This pattern suggests that interactions among multiple social and attentional brain systems over the first two years give rise to variable pathways in infants at-risk.

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          Most cited references 49

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          Early social attention impairments in autism: social orienting, joint attention, and attention to distress.

          This study investigated social attention impairments in autism (social orienting, joint attention, and attention to another's distress) and their relations to language ability. Three- to four-year-old children with autism spectrum disorder (ASD; n = 72), 3- to 4-year-old developmentally delayed children (n = 34), and 12- to 46-month-old typically developing children (n = 39), matched on mental age, were compared on measures of social orienting, joint attention, and attention to another's distress. Children with autism performed significantly worse than the comparison groups in all of these domains. Combined impairments in joint attention and social orienting were found to best distinguish young children with ASD from those without ASD. Structural equation modeling indicated that joint attention was the best predictor of concurrent language ability. Social orienting and attention to distress were indirectly related to language through their relations with joint attention. These results help to clarify the nature of social attention impairments in autism, offer clues to developmental mechanisms, and suggest targets for early intervention. ((c) 2004 APA, all rights reserved)
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            The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology.

            The Development and Well-Being Assessment (DAWBA) is a novel package of questionnaires, interviews, and rating techniques designed to generate ICD-10 and DSM-IV psychiatric diagnoses on 5-16-year-olds. Nonclinical interviewers administer a structured interview to parents about psychiatric symptoms and resultant impact. When definite symptoms are identified by the structured questions, interviewers use open-ended questions and supplementary prompts to get parents to describe the problems in their own words. These descriptions are transcribed verbatim by the interviewers but are not rated by them. A similar interview is administered to 11-16-year-olds. Teachers complete a brief questionnaire covering the main conduct, emotional, and hyperactivity symptoms and any resultant impairment. The different sorts of information are brought together by a computer program that also predicts likely diagnoses. These computer-generated summary sheets and diagnoses form a convenient starting point for experienced clinical raters, who decide whether to accept or overturn the computer diagnosis (or lack of diagnosis) in the light of their review of all the data, including transcripts. In the present study, the DAWBA was administered to community (N = 491) and clinic (N = 39) samples. There was excellent discrimination between community and clinic samples in rates of diagnosed disorder. Within the community sample, subjects with and without diagnosed disorders differed markedly in external characteristics and prognosis. In the clinic sample, there was substantial agreement between DAWBA and case note diagnoses, though the DAWBA diagnosed more comorbid disorders. The use of screening questions and skip rules greatly reduced interview length by allowing many sections to be omitted with very little loss of positive information. Overall, the DAWBA successfully combined the cheapness and simplicity of respondent-based measures with the clinical persuasiveness of investigator-based diagnoses. The DAWBA has considerable potential as an epidemiological measure, and may prove to be of clinical value too.
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              Understanding the nature of face processing impairment in autism: insights from behavioral and electrophysiological studies.

              This article reviews behavioral and electrophysiological studies of face processing and discusses hypotheses for understanding the nature of face processing impairments in autism. Based on results of behavioral studies, this study demonstrates that individuals with autism have impaired face discrimination and recognition and use atypical strategies for processing faces characterized by reduced attention to the eyes and piecemeal rather than configural strategies. Based on results of electrophysiological studies, this article concludes that face processing impairments are present early in autism, by 3 years of age. Such studies have detected abnormalities in both early (N170 reflecting structural encoding) and late (NC reflecting recognition memory) stages of face processing. Event-related potential studies of young children and adults with autism have found slower speed of processing of faces, a failure to show the expected speed advantage of processing faces versus nonface stimuli, and atypical scalp topography suggesting abnormal cortical specialization for face processing. Other electrophysiological studies have suggested that autism is associated with early and late stage processing impairments of facial expressions of emotion (fear) and decreased perceptual binding as reflected in reduced gamma during face processing. This article describes two types of hypotheses-cognitive/perceptual and motivational/affective--that offer frameworks for understanding the nature of face processing impairments in autism. This article discusses implications for intervention.

                Author and article information

                Behav Brain Res
                Behav. Brain Res
                Behavioural Brain Research
                Elsevier/North-Holland Biomedical Press
                15 August 2013
                15 August 2013
                : 251
                : 100
                : 147-154
                [a ]Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
                [b ]Centre for Brain and Cognitive Development, School of Psychology, Birkbeck College, University of London, Malet Street, London, WC1E 7HX, United Kingdom
                [c ]Institute of Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
                [d ]Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Australia
                [e ]Centre for Research in Autism and Education, Department of Psychology and Human Development, Institute of Education, 25 Woburn Square, London, WC1H OAA, United Kingdom
                Author notes
                [* ]Corresponding author at: Montreal Children's Hospital, 4018 Ste-Catherine West, Office: 145 Lab: 131, Montreal, QC, H3Z 1P2, Canada. Tel.: +1 514 412 4400x23076; fax: +1 514 412 4337. mayada.elsabbagh@ 123456mcgill.ca

                The BASIS Team in alphabetical order Simon Baron-Cohen, Rachael Bedford, Patrick Bolton, Susie Chandler, Janice Fernandes, Holly Garwood, Noreen Gilhooly, Leslie Tucker, Greg Pasco, Agnes Volein.

                © 2013 Elsevier B.V.

                This document may be redistributed and reused, subject to certain conditions.

                Research Report


                autism, infancy, at-risk, face-processing, attention, prospective study


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