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CAPILLARY PERFUSION
Black et al 1987Sirevaag et al 1988
SYNAPSESRampon et al 2000 Turner et al 2003Greenoughand Chang Review
NEUROGENESIS
Kempermann et al 1997Brown et al 2003
DENDRITIC BRANCHING
VolkmarampGreenough 1972Greenough et al 1986
AGE
PL
AS
TIC
ITY High
Low
Infancy Childhood Adulthood
SUBJECTS
bull 136 infants abandoned at birth in Bucharest Romania and institutionalized
bull 68 Foster Care (FCG)
bull 68 Remained Institutionalized (IG)
bull 72 Never Institutionalized (NIG) reared at Home with Biological Parents
bullDV = Bailey Scale of Infant Development (Baseline 30 amp 42 mo) and WPPSI at 50 mo
Foster Care DQ at 42 months BY AGE OF PLACEMENT
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
AGE
PL
AS
TIC
ITY High
Low
Infancy Childhood Adulthood
SUBJECTS
bull 136 infants abandoned at birth in Bucharest Romania and institutionalized
bull 68 Foster Care (FCG)
bull 68 Remained Institutionalized (IG)
bull 72 Never Institutionalized (NIG) reared at Home with Biological Parents
bullDV = Bailey Scale of Infant Development (Baseline 30 amp 42 mo) and WPPSI at 50 mo
Foster Care DQ at 42 months BY AGE OF PLACEMENT
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
SUBJECTS
bull 136 infants abandoned at birth in Bucharest Romania and institutionalized
bull 68 Foster Care (FCG)
bull 68 Remained Institutionalized (IG)
bull 72 Never Institutionalized (NIG) reared at Home with Biological Parents
bullDV = Bailey Scale of Infant Development (Baseline 30 amp 42 mo) and WPPSI at 50 mo
Foster Care DQ at 42 months BY AGE OF PLACEMENT
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
bullDV = Bailey Scale of Infant Development (Baseline 30 amp 42 mo) and WPPSI at 50 mo
Foster Care DQ at 42 months BY AGE OF PLACEMENT
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Foster Care DQ at 42 months BY AGE OF PLACEMENT
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Talk or babble in a voice with an unusual tone
Display extreme sensory sensitivities
Play with toys in an unusual manner
Carry around an objects for extended periods of time These items might seem unusual or usual
Display unusual body or hand movements
Seem overly fussy or be difficult to soothe
Point at things
Babble or talk back and forth with another person
Smile in response to your smile
Make good eye contact
Show objects to othersRespond to their name
Enjoy cuddling
Show shared enjoyment
Say their first word by 12-14 mo
MIGHT NOT MIGHT
Try to gain the attention of others
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
bull Baron-Cohen Cox Baird Swettenham Nightingale Morgan Drew amp Charman (1992)
bull Landa Holman amp Garrett-Mayer (2007)
bull Werner Dawson Osterling amp Dinno (2000)
bull Osterling amp Dawson (1994)
bull Osterling Dawson amp Munson (2002)
bull Zwaigenbaum Bryson Rogers Roberts Brian amp Szatmari (2005)
bull Wetherby Woods Allen Cleary Dickinson amp Lord (2004)
bull Vostanis Smith Corbett Sungum-Paliwal Edwards Gingell Golding Moore amp Williams (1998)
bull Luyster Gotham Guthrie Coffing Petrak Pierce Bishop Esler Hus Oti Richler Risi amp Lord (2009)
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
The ldquoBaby Sibrdquo Approach
95 (or 90)
Normal(With up to 10 with language or social problems)
ASD
4-5(or up to 15)
bull Need to study 100 babies just to find 4 or 5 or 15with an ASD
bull Study autism from birth
bull Studies autism only in multiplexfamilies ndash are genetics different
(Sebat et al 2007)
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
visual trackingeye contact
attentional disengagementcoordination of eye gaze and actionimitationaffective responsessocial communicativebehaviors
sensory motor behaviorsorienting to namesocial smilingbehavioral reactivitysocial interest
No Difference at 6 months Differences at 12 months(7 AD and 12 Spectrum at 24 mo)
ldquoThere are no overalldifferences in the number of behavioral markers observed at 6 months between siblingswith an ADOS classification lt Of ASDgt at 24 months and other infantsrdquo
Autism Observation Scale for Infants
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
1 Yr Well-Baby Check-Up Approach
bull Fast
bull Easy
bull Investigates autism asit occurs in the population
Pierce Carter Weinfeld Desmond Hazin Gallagher Bjork in Review
bull Investigates the feasibilityof on-site screening and scoringas pediatric standard of care
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Social Communication Composite
Expressive Speech
Composite
Symbolic Composite
Wetherby ampPrizant 2002
CSBS DP Infant-Toddler Checklist
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Dr Robert Bjork Dr Michael Nelson Dr Cheryl JennettDr Dr John Kafa Dr Douglas Wilson Dr Crystal De FreitasDr Martin Gilboa Dr Patricia Juarez Dr George Madany Dr Seven Brody Dr Ingrid Martinez-Andree Dr Irene ChangDr Stephanie Powell Dr Adam Breslow Dr Patricia PisingerDr Isabel Baratta Dr Sheila Cason Dr Thomas NegliaDr Stephen Balch Dr Randall Metsch Dr David SchmottlachDr Sonja Brion Dr Anna Mendenhall Dr Nancy ClementinoDr Marshall Littman Dr Leslie McCormick Dr Sharon SternfeldDr Cara Cohen Dr Nicholas Tsoulos Dr Elena FishmanDr Hilary Bowers Dr Albert Martinez Dr Genevieve Minka
Dr Wendy Chacon Dr Leon Kelley Dr Victor Lipps Dr Jeffrey Selzer Dr Lynn Herring Dr Teresa Orsquodea Dr Richard Walls Dr Vivian Tung Dr Christian Archambault Dr Veronique James Dr Stuart Cohen Dr Nancy Shiau Dr Linda Smith Dr Tevor Henderson Dr Cheryl Morrell Dr Josef Zwass Dr Lon Dubeye Dr Andrea Siano Dr Aida Martinez Dr Rachel Ireland Dr Louis Luevanos Dr Laurie Tyrrell Dr John Cella Dr Jill Gustafson Dr Rosemary Page Dr David Steele Dr Carlos Quiros Dr Brian Chu Dr Kathleen Jones Dr James Moseman Dr Laurence Ashbacher Dr Theresa Dailey Dr Frederick FruminDr Nicholas Levy Dr Julie Snyder Block Dr Lori Taylor Dr Rosalind Dockweiler Dr Christine Wood Dr William Hitchcock Dr Robert Warner Dr Sheetal Gandhi Dr Suzanne Mills Dr Mona Sobel Dr Craig Duck Dr James Hay Dr Georgine Jorgensen Dr Richard Payne Dr James Quigley Dr Richard Buchta Dr Ann Marie Engfelt Dr Benjamin Siegel Dr Lori Gould Dr Micelle Sanford Dr Annie Kupelian Dr Paula Grayson Dr Raha Shaw Dr Gary Chun Dr Matilda Remba Dr Janna Cataldo Dr Nicole Gorton Dr Bret Gerber Dr Denise Brownlee Dr Stuart Rubenstein Dr Peggy Manuel Dr Veda Wu Dr Michael Berent Dr GargiKubal Dr Norman Gollub Dr Teresa Hardisty Dr Jeanne Montal Dr Katrina Durkee Dr Kamei Tolba Dr Carol Hart Dr Dennis Butler Dr Howard Mehl Dr Marta Awdykovych Dr UmaNarayan Dr Richard McNeal Dr Marta Awdykovych Dr Richard McNeal Dr Jennie Ou Dr Howard Smart Dr NeethiRatnesar Dr Fujii Dr Mattson Dr Norman Dr Sauer Dr Gabriela Mogrovejo Dr Julie Keeler Dr Liz Hourihan Dr Dania Lindenberg Dr Dori Mortimer Dr Marvin Zaguli
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Comprehensive Developmental Tracking
Private Consultation
and test score review
12 months
Language
Cognitive
ADOSExperiment
al
18 months
Private Consultation
and test score review
24months
Language
Cognitive
ADOSExperiment
al
30 months
36 months
Language
Cognitive
ADOS
Final Diagnosis ADI
Private Consultation
And test score review
Experimental
asymp Two hours per visit Two visits per age pointAlso Includes parent interview
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Analyzing Patterns of Eye GazePredictors of Risk for an ASD
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Goren 1975 Replicated by Johnson 1991
9 MINUTE old infants prefer faces over non-face patterns
Typical Infants are Socially Interested
3-4 Month old infants prefer happy to angry sounds
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Klin et al 2002
Viewer with Autism Viewer with Typical Dev
Am J Psychiatry 1596 June 2002
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
ldquo Results revealed that none of the 6-month old infants previously identified as showing lower rates of eye contact had any signs of autism at outcome ldquo
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Pierce et al (2010) Archives of General Psychiatry
N AGE ADOS Total
MULLEN
ASD 37 26 mo(14-43 mo)
16(8-22)
6853-101
DD 22 22 mo(12-41 mo)
6(0-7)
7135-84
Typical 51 24 mo(12-43 mo)
18(0-7)
10988-132
138 Toddlers Age Range 12-43 Months
(28) Poor Calibration Fussy Technical issues Looked away gt 50 of trials
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
WHAT TO LOOK FOR1PREFERENCE FOR SOCIAL IMAGES
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Pierce et al 2010
14 months15 months
16 months
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Sleep MRI
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
2-year old with autismBefore Surgery
2-Year old with autism After Surgery
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
CUTE HAT
DO
G
WOW
How
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Why study LANGUAGE
Charman et al 2003Birth 8 12 24 36Voc
abul
ary
(wor
ds)
50
600
300
16Age (mo)
118
Comprehension
Production
Prod
uctio
n
Com
preh
ensi
onIMPAIRED Pragmatics (Tager-Flusberg et al 2005)PhonologySyntaxSemantics
UNUSUAL FEATURES Odd Inflection and Prosody (usually monotone) Stereotyped speechImmediate and delayed echolalia
Slide courtesy E Redcay
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Why study LATERALITY
bull Hemispheric specialization is crucial aspect of language development
bull Structural asymmetries in language areas prenatal in origin
bull In older children and adults left hemisphere predominance of language response especially in frontal and temporal cortex
bull Greater right hemisphere involvement in pragmaticsbull Less known about normal development of functional
asymmetries or how this may go awry in ASD
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
From Dehaene-Lambertz et al (2002 Science)
3 month old infant
Brain Response to Speech During Sleep
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Current Studybull Goals
ndash Extend prior work to include infants and toddlers with subsequent confirmation of ASD
ndash Examine development of left-hemisphere predominance of language response in typical children and laterality abnormalities in ASD
bull ParticipantsASD (n=23) Typical (n=20)
Mean Age in months 321 252
Age Range in months 145 - 476 132 - 453
Number of boys 18 11
Mullen Receptive Language Age in months 202 253
Mullen Receptive Visual Age in months 276 239
ADOS Score 133 19
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Brain Response to a Bedtime Story in Sleeping Infants and Toddlers
10
00
Effect Size (Eta2)
Typical (n=20)
ASD (n=23)
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
UCSD AUTISM CENTER OF EXCELLENCEExploration Patterns
Resting Functional Connectivity
Brain Response to Emotion Sounds
Language Profile
Patterns of Eye Gaze
Gene Expression
Gene Association
Brain Growth Trajectory
White Matter Profile
Play Behavior
Blood Based Immune Markers
Cortical Thickness
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
Thank You
Taran
Sierra
Eric Courchesnewwwautismsandiegoorg
