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1. A Six‐Minute Measure of Vocalizations in Toddlers with Autism Spectrum Disorder

   https://doi.org/10.1002/aur.2293  

   Tenenbaum, Elena J. ; Carpenter, Kimberly L. H. ; Sabatos‐DeVito, Maura ; Hashemi, Jordan ; Vermeer, Saritha ; Sapiro, Guillermo ; Dawson, Geraldine ( March 2020 , Autism Research)

   To improve early identification of autism spectrum disorder (ASD), we need objective, reliable, and accessible measures. To that end, a previous study demonstrated that a tablet‐based application (app) that assessed several autism risk behaviors distinguished between toddlers with ASD and non‐ASD toddlers. Using vocal data collected during this study, we investigated whether vocalizations uttered during administration of this app can distinguish among toddlers aged 16–31 months with typical development (TD), language or developmental delay (DLD), and ASD. Participant's visual and vocal responses were recorded using the camera and microphone in a tablet while toddlers watched movies designed to elicit behaviors associated with risk for ASD. Vocalizations were then coded offline. Results showed that (a) children with ASD and DLD were less likely to produce words during app administration than TD participants; (b) the ratio of syllabic vocalizations to all vocalizations was higher among TD than ASD or DLD participants; and (c) the rates of nonsyllabic vocalizations were higher in the ASD group than in either the TD or DLD groups. Those producing more nonsyllabic vocalizations were 24 times more likely to be diagnosed with ASD. These results lend support to previous findings that early vocalizations might be useful in identifying risk for ASD in toddlers and demonstrate the feasibility of using a scalable tablet‐based app for assessing vocalizations in the context of a routine pediatric visit.

   Although parents often report symptoms of autism spectrum disorder (ASD) in infancy, we are not yet reliably diagnosing ASD until much later in development. A previous study tested a tablet‐based application (app) that recorded behaviors we know are associated with ASD to help identify children at risk for the disorder. Here we measured how children vocalize while they watched the movies presented on the tablet. Children with ASD were less likely to produce words, less likely to produce speechlike sounds, and more likely to produce atypical sounds while watching these movies. These measures, combined with other behaviors measured by the app, might help identify which children should be evaluated for ASD.Autism Res2020, 13: 1373–1382. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

    

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2. Digital Behavioral Phenotyping Detects Atypical Pattern of Facial Expression in Toddlers with Autism

   https://doi.org/10.1002/aur.2391  

   Carpenter, Kimberly L. H. ; Hahemi, Jordan ; Campbell, Kathleen ; Lippmann, Steven J. ; Baker, Jeffrey P. ; Egger, Helen L. ; Espinosa, Steven ; Vermeer, Saritha ; Sapiro, Guillermo ; Dawson, Geraldine ( September 2020 , Autism Research)

   Commonly used screening tools for autism spectrum disorder (ASD) generally rely on subjective caregiver questionnaires. While behavioral observation is more objective, it is also expensive, time‐consuming, and requires significant expertise to perform. As such, there remains a critical need to develop feasible, scalable, and reliable tools that can characterize ASD risk behaviors. This study assessed the utility of a tablet‐based behavioral assessment for eliciting and detecting one type of risk behavior, namely, patterns of facial expression, in 104 toddlers (ASDN= 22) and evaluated whether such patterns differentiated toddlers with and without ASD. The assessment consisted of the child sitting on his/her caregiver's lap and watching brief movies shown on a smart tablet while the embedded camera recorded the child's facial expressions. Computer vision analysis (CVA) automatically detected and tracked facial landmarks, which were used to estimate head position and facial expressions (Positive, Neutral, All Other). Using CVA, specific points throughout the movies were identified that reliably differentiate between children with and without ASD based on their patterns of facial movement and expressions (area under the curves for individual movies ranging from 0.62 to 0.73). During these instances, children with ASD more frequently displayed Neutral expressions compared to children without ASD, who had more All Other expressions. The frequency of All Other expressions was driven by non‐ASD children more often displaying raised eyebrows and an open mouth, characteristic of engagement/interest. Preliminary results suggest computational coding of facial movements and expressions via a tablet‐based assessment can detect differences in affective expression, one of the early, core features of ASD.

   This study tested the use of a tablet in the behavioral assessment of young children with autism. Children watched a series of developmentally appropriate movies and their facial expressions were recorded using the camera embedded in the tablet. Results suggest that computational assessments of facial expressions may be useful in early detection of symptoms of autism.

    

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3. Sensory Responsiveness Is Linked With Communication in Infant Siblings of Children With and Without Autism

   https://doi.org/10.1044/2021_JSLHR-20-00196  

   Feldman, Jacob I. ; Raj, Sweeya ; Bowman, Sarah M. ; Santapuram, Pooja ; Golden, Alexandra J. ; Daly, Claire ; Dunham, Kacie ; Suzman, Evan ; Augustine, Ashley E. ; Garla, Varsha ; et al ( June 2021 , Journal of Speech, Language, and Hearing Research)

   null (Ed.)

   Purpose Differences in communication development impact long-term outcomes of children with autism. Previous research has identified factors associated with communication in children with autism, but much of the variance in communication skill remains unexplained. It has been proposed that early differences in sensory responsiveness (i.e., hyporesponsiveness, hyperresponsiveness, and sensory seeking) may produce “cascading effects” on communication. Evidence for this theory is limited, however, as relations between sensory responsiveness and communication in the earliest stages of development have not been well established. The purpose of this study was to evaluate (a) whether infants with a heightened likelihood of autism diagnosis (i.e., infants with an older sibling with autism) differ from infants at general population–level likelihood of autism (i.e., infants with an older, nonautistic sibling) on patterns of sensory responsiveness, (b) whether early sensory responsiveness is correlated with concurrent communication, and (c) whether the aforementioned between-groups differences and associations are moderated by age. Method Participants were 40 infants (20 infants with an older sibling with autism, 20 infants with an older, nonautistic sibling) aged 12–18 months. A series of observational and parent report measures of sensory responsiveness and communication skill were administered. Results Group differences in sensory responsiveness across the 12- to 18-month period were limited (i.e., only observed for one measure of hyporesponsiveness), though selected differences in sensory responsiveness (i.e., parent-reported hyperresponsiveness and sensory seeking) emerged between groups over this developmental window. Parent-reported hyporesponsiveness was unconditionally, negatively associated with communication skills. Associations between expressive communication and (a) parent-reported sensory seeking and (b) an observational measure of hyperresponsiveness were moderated by age. Conclusions This study provides new insights into the nature of sensory responsiveness and theorized links with communication skill in infants at elevated and general population–level likelihood of autism diagnosis. Further work is needed to better characterize the effects of interest in a larger sample spanning a wider age range. Supplemental Material https://doi.org/10.23641/asha.14515542 

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4. Quantifying latent social motivation and its associations with joint attention and language in infants at high and low likelihood for autism spectrum disorder

   https://doi.org/10.1111/desc.13336  

   Stallworthy, Isabella C. ; Berry, Daniel ; Davis, Savannah ; Wolff, Jason J. ; Burrows, Catherine A. ; Swanson, Meghan R. ; Grzadzinski, Rebecca L. ; Botteron, Kelly ; Dager, Stephen R. ; Estes, Annette M. ; et al ( October 2022 , Developmental Science)

   Social motivation—the psychobiological predisposition for social orienting, seeking social contact, and maintaining social interaction—manifests in early infancy and is hypothesized to be foundational for social communication development in typical and atypical populations. However, the lack of infant social‐motivation measures has hindered delineation of associations between infant social motivation, other early‐arising social abilities such as joint attention, and language outcomes. To investigate how infant social motivation contributes to joint attention and language, this study utilizes a mixed longitudinal sample of 741 infants at high (HL = 515) and low (LL = 226) likelihood for ASD. Using moderated nonlinear factor analysis (MNLFA), we incorporated items from parent‐report measures to establish a novel latent factor model of infant social motivation that exhibits measurement invariance by age, sex, and familial ASD likelihood. We then examined developmental associations between 6‐ and 12‐month social motivation, joint attention at 12–15 months, and language at 24 months of age. On average, greater social‐motivation growth from 6–12 months was associated with greater initiating joint attention (IJA) and trend‐level increases in sophistication of responding to joint attention (RJA). IJA and RJA were both positively associated with 24‐month language abilities. There were no additional associations between social motivation and future language in our path model. These findings substantiate a novel, theoretically driven approach to modeling social motivation and suggest a developmental cascade through which social motivation impacts other foundational skills. These findings have implications for the timing and nature of intervention targets to support social communication development in infancy.

   We describe a novel, theoretically based model of infant social motivation wherein multiple parent‐reported indicators contribute to a unitary latent social‐motivation factor.

   Analyses revealed social‐motivation factor scores exhibited measurement invariance for a longitudinal sample of infants at high and low familial ASD likelihood.

   Social‐motivation growth from ages 6–12 months is associated with better 12−15‐month joint attention abilities, which in turn are associated with greater 24‐month language skills.

   Findings inform timing and targets of potential interventions to support healthy social communication in the first year of life.

    

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5. Preventing Cardiovascular Disease Among Urban African Americans With a Mobile Health App (the MOYO App): Protocol for a Usability Study

   https://doi.org/10.2196/16699  

   Taylor Jr, Herman A ; Francis, Sherilyn ; Evans, Chad Ray ; Harvey, Marques ; Newton, Brittney A ; Jones, Camara P ; Akintobi, Tabia Henry ; Clifford, Gari ( January 2020 , JMIR Research Protocols)

   null (Ed.)

   Background Cardiovascular disease (CVD) disparities are a particularly devastating manifestation of health inequity. Despite advancements in prevention and treatment, CVD is still the leading cause of death in the United States. Additionally, research indicates that African American (AA) and other ethnic-minority populations are affected by CVD at earlier ages than white Americans. Given that AAs are the fastest-growing population of smartphone owners and users, mobile health (mHealth) technologies offer the unparalleled potential to prevent or improve self-management of chronic disease among this population. Objective To address the unmet need for culturally tailored primordial prevention CVD–focused mHealth interventions, the MOYO app was cocreated with the involvement of young people from this priority community. The overall project aims to develop and evaluate the effectiveness of a novel smartphone app designed to reduce CVD risk factors among urban-AAs, 18-29 years of age. Methods The theoretical underpinning will combine the principles of community-based participatory research and the agile software development framework. The primary outcome goals of the study will be to determine the usability, acceptability, and functionality of the MOYO app, and to build a cloud-based data collection infrastructure suitable for digital epidemiology in a disparity population. Changes in health-related parameters over a 24-week period as determined by both passive (eg, physical activity levels, sleep duration, social networking) and active (eg, use of mood measures, surveys, uploading pictures of meals and blood pressure readings) measures will be the secondary outcome. Participants will be recruited from a majority AA “large city” school district, 2 historically black colleges or universities, and 1 urban undergraduate college. Following baseline screening for inclusion (administered in person), participants will receive the beta version of the MOYO app. Participants will be monitored during a 24-week pilot period. Analyses of varying data including social network dynamics, standard metrics of activity, percentage of time away from a given radius of home, circadian rhythm metrics, and proxies for sleep will be performed. Together with external variables (eg, weather, pollution, and socioeconomic indicators such as food access), these metrics will be used to train machine-learning frameworks to regress them on the self-reported quality of life indicators. Results This 5-year study (2015-2020) is currently in the implementation phase. We believe that MOYO can build upon findings of classical epidemiology and longitudinal studies like the Jackson Heart Study by adding greater granularity to our knowledge of the exposures and behaviors that affect health and disease, and creating a channel for outreach capable of launching interventions, clinical trials, and enhancements of health literacy. Conclusions The results of this pilot will provide valuable information about community cocreation of mHealth programs, efficacious design features, and essential infrastructure for digital epidemiology among young AA adults. International Registered Report Identifier (IRRID) DERR1-10.2196/16699 

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