Social visual engagement difficulties are hallmark early signs of autism (ASD) and are easily quantified using eye tracking methods. However, it is unclear how these difficulties are linked to ...atypical early functional brain organization in ASD. With resting state fMRI data in a large sample of ASD toddlers and other non-ASD comparison groups, we find ASD-related functional hypoconnnectivity between 'social brain' circuitry such as the default mode network (DMN) and visual and attention networks. An eye tracking-identified ASD subtype with pronounced early social visual engagement difficulties (GeoPref ASD) is characterized by marked DMN-occipito-temporal cortex (OTC) hypoconnectivity. Increased DMN-OTC hypoconnectivity is also related to increased severity of social-communication difficulties, but only in GeoPref ASD. Early and pronounced social-visual circuit hypoconnectivity is a key underlying neurobiological feature describing GeoPref ASD and may be critical for future social-communicative development and represent new treatment targets for early intervention in these individuals.
IMPORTANCE: Universal early screening for autism spectrum disorder (ASD) in primary care is becoming increasingly common and is believed to be a pivotal step toward early treatment. However, the ...diagnostic stability of ASD in large cohorts from the general population, particularly in those younger than 18 months, is unknown. Changes in the phenotypic expression of ASD across early development compared with toddlers with other delays are also unknown. OBJECTIVES: To examine the diagnostic stability of ASD in a large cohort of toddlers starting at 12 months of age and to compare this stability with that of toddlers with other disorders, such as developmental delay. DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study performed from January 1, 2006, to December 31, 2018, a total of 2241 toddlers were referred from the general population through a universal screening program in primary care or community referral. Eligible toddlers received their first diagnostic evaluation between 12 and 36 months of age and had at least 1 subsequent evaluation. EXPOSURES: Diagnosis was denoted after each evaluation visit as ASD, ASD features, language delay, developmental delay, other developmental issue, typical sibling of an ASD proband, or typical development. MAIN OUTCOMES AND MEASURES: Diagnostic stability coefficients were calculated within 2-month age bands, and logistic regression models were used to explore the associations of sex, age, diagnosis at first visit, and interval between first and last diagnosis with stability. Toddlers with a non-ASD diagnosis at their first visit diagnosed with ASD at their last were designated as having late-identified ASD. RESULTS: Among the 1269 toddlers included in the study (918 72.3% male; median age at first evaluation, 17.6 months interquartile range, 14.0-24.4 months; median age at final evaluation, 36.2 months interquartile range, 33.4-40.9 months), the overall diagnostic stability for ASD was 0.84 (95% CI, 0.80-0.87), which was higher than any other diagnostic group. Only 7 toddlers (1.8%) initially considered to have ASD transitioned into a final diagnosis of typical development. Diagnostic stability of ASD within the youngest age band (12-13 months) was lowest at 0.50 (95% CI, 0.32-0.69) but increased to 0.79 by 14 months and 0.83 by 16 months (age bands of 12 vs 14 and 16 years; odds ratio, 4.25; 95% CI, 1.59-11.74). A total of 105 toddlers (23.8%) were not designated as having ASD at their first visit but were identified at a later visit. CONCLUSIONS AND RELEVANCE: The findings suggest that an ASD diagnosis becomes stable starting at 14 months of age and overall is more stable than other diagnostic categories, including language or developmental delay. After a toddler is identified as having ASD, there may be a low chance that he or she will test within typical levels at 3 years of age. This finding opens the opportunity to test the impact of very early-age treatment of ASD.
Heterogeneity in early language development in autism spectrum disorder (ASD) is clinically important and may reflect neurobiologically distinct subtypes. Here, we identified a large-scale ...association between multiple coordinated blood leukocyte gene coexpression modules and the multivariate functional neuroimaging (fMRI) response to speech. Gene coexpression modules associated with the multivariate fMRI response to speech were different for all pairwise comparisons between typically developing toddlers and toddlers with ASD and poor versus good early language outcome. Associated coexpression modules were enriched in genes that are broadly expressed in the brain and many other tissues. These coexpression modules were also enriched in ASD-associated, prenatal, human-specific, and language-relevant genes. This work highlights distinctive neurobiology in ASD subtypes with different early language outcomes that is present well before such outcomes are known. Associations between neuroimaging measures and gene expression levels in blood leukocytes may offer a unique in vivo window into identifying brain-relevant molecular mechanisms in ASD.
Cross-sectional magnetic resonance imaging (MRI) studies have long hypothesized that the brain in children with autism undergoes an abnormal growth trajectory that includes a period of early ...overgrowth; however, this has never been confirmed by a longitudinal study. We performed the first longitudinal study of brain growth in toddlers at the time symptoms of autism are becoming clinically apparent using structural MRI scans at multiple time points beginning at 1.5 years up to 5 years of age. We collected 193 scans on 41 toddlers who received a confirmed diagnosis of autistic disorder at approximately 48 months of age and 44 typically developing controls. By 2.5 years of age, both cerebral gray and white matter were significantly enlarged in toddlers with autistic disorder, with the most severe enlargement occurring in frontal, temporal, and cingulate cortices. In the longitudinal analyses, which we accounted for age and gender effect, we found that all regions (cerebral gray, cerebral white, frontal gray, temporal gray, cingulate gray, and parietal gray) except occipital gray developed at an abnormal growth rate in toddlers with autistic disorder that was mainly characterized by a quadratic age effect. Females with autistic disorder displayed a more pronounced abnormal growth profile in more brain regions than males with the disorder. Given that overgrowth clearly begins before 2 years of age, future longitudinal studies would benefit from inclusion of even younger populations as well as further characterization of genetic and other biomarkers to determine the underlying neuropathological processes causing the onset of autistic symptoms.
While many children with autism spectrum disorder are now detected at young ages given the rise in screening and general awareness, little is known regarding the prognosis of early detected children. ...The brain is shaped by experience-dependent mechanisms; thus, what a child pays attention to plays a pivotal role in shaping brain development. Eye tracking can provide an index of a child’s visual attention and, as such, holds promise as a technology for revealing prognostic markers. In this, 49 children aged 1–3 years with autism spectrum disorder participated in an eye-tracking test, the GeoPref Test, that revealed preference for social versus nonsocial images. Next, children participated in a comprehensive test battery 5–9 years following the initial GeoPref Test. Statistical tests examined whether early age eye tracking predicted later school-age outcomes in symptom severity, social functioning, adaptive behavior, joint attention, and IQ. Results indicated that toddlers with higher preference for geometric images demonstrated greater symptom severity and fewer gaze shifts at school age. This relationship was not found in relation to IQ or adaptive behavior. Overall, the GeoPref Test holds promise as a symptom severity prognostic tool; further development of eye-tracking paradigms may enhance prognostic power and prove valuable in validating treatment progress.
Background Autism is a heterogeneous neurodevelopmental disorder of unknown etiology. The amygdala has long been a site of intense interest in the search for neuropathology in autism, given its role ...in emotional and social behavior. An interesting hypothesis has emerged that the amygdala undergoes an abnormal developmental trajectory with a period of early overgrowth in autism; however this finding has not been well established at young ages nor analyzed with boys and girls independently. Methods We measured amygdala volumes on magnetic resonance imaging scans from 89 toddlers at 1–5 years of age (mean = 3 years). Each child returned at ∼5 years of age for final clinical evaluation. Results Toddlers who later received a confirmed autism diagnosis (32 boys, 9 girls) had a larger right ( p < .01) and left ( p < .05) amygdala compared with typically developing toddlers (28 boys, 11 girls) with and without covarying for total cerebral volume. Amygdala size in toddlers with autism spectrum disorder correlated with the severity of their social and communication impairments as measured on the Autism Diagnostic Interview and Vineland scale. Strikingly, girls differed more robustly from typical in amygdala volume, whereas boys accounted for the significant relationship of amygdala size with severity of clinical impairment. Conclusions This study provides evidence that the amygdala is enlarged in young children with autism; the overgrowth must begin before 3 years of age and is associated with the severity of clinical impairments. However, neuroanatomic phenotypic profiles differ between males and females, which critically affects future studies on the genetics and etiology of autism.
Natural language helps express mathematical thinking and contexts. Conventional mathematical notation (CMN) best suits expressions and equations. Each is essential; each also has limitations, ...especially for learners. Our research studies how programming can be a advantageous third language that can also help restore mathematical connections that are hidden by topic‐centred curricula. Restoring opportunities for surprise and delight reclaims mathematics' creative nature. Studies of children's use of language in mathematics and their programming behaviours guide our iterative design/redesign of mathematical microworlds in which students, ages 7–11, use programming in their regular school lessons as a language for learning mathematics. Though driven by mathematics, not coding, the microworlds develop the programming over time so that it continues to support children's developing mathematical ideas. This paper briefly describes microworlds EDC has tested with well over 400 7‐to‐8‐year‐olds in school, and others tested (or about to be tested) with over 200 8‐to‐11‐year‐olds. Our challenge was to satisfy schools' topical orientation and fit easily within regular classroom study but use and foreshadow other mathematical learning to remove the siloes. The design/redesign research and evaluation is exploratory, without formal methodology. We are also more formally studying effects on children's learning. That ongoing study is not reported here.
Practitioner notes
What is already known
Active learning—doing—supports learning.
Collaborative learning—doing together—supports learning.
Classroom discourse—focused, relevant discussion, not just listening—supports learning.
Clear articulation of one's thinking, even just to oneself, helps develop that thinking.
What this paper adds
The common languages we use for classroom mathematics—natural language for conveying the meaning and context of mathematical situations and for explaining our reasoning; and the formal (written) language of conventional mathematical notation, the symbols we use in mathematical expressions and equations—are both essential but each presents hurdles that necessitate the other. Yet, even together, they are insufficient especially for young learners.
Programming, appropriately designed and used, can be the third language that both reduces barriers and provides the missing expressive and creative capabilities children need.
Appropriate design for use in regular mathematics classrooms requires making key mathematical content obvious, strong and the ‘driver’ of the activities, and requires reducing tech ‘overhead’ to near zero.
Continued usefulness across the grades requires developing children's sophistication and knowledge with the language; the powerful ways that children rapidly acquire facility with (natural) language provides guidance for ways they can learn a formal language as well.
Implications for policy and/or practice
Mathematics teaching can take advantage of the ways children learn through experimentation and attention to the results, and of the ways children use their language brain even for mathematics.
In particular, programming—in microworlds driven by the mathematical content, designed to minimise distraction and overhead, open to exploration and discovery en route to focused aims, and in which children self‐evaluate—can allow clear articulation of thought, experimentation with immediate feedback.
As it aids the mathematics, it also builds computational thinking and satisfies schools' increasing concerns to broaden access to ideas of computer science.
This paper connects the technological practice of activity monitor gaming to the Next Generation Science Standards (NGSS) science and engineering practice of “analyzing and interpreting data,” and to ...the foundational constructionist idea of personal meaning. In our larger study, eighth-grade students, ages 12–14, wore physical activity monitor devices for approximately four months, encountered their own and peers’data on device displays and dashboards, and played a game designed by the project team that converted their device data into game bonuses and player actions. The analysis for this article examined focus groups and individual interviews with students from the project to determine alignment between students’ thinking and the NGSS “analyzing and interpreting data” practices for grades 6–8: considering limitations related to measurement accuracy and error, measurement tools, and appropriateness of the data collection model. The analysis also identified what types of student experiences and reflections could be characterized as constructionist components of knowledge generation and knowledge reformulation, both of which are key to NGSS recommendations around finding “relevance” in data. Findings revealed that while students engaged in all three types of consideration, as well as creating meaningful interpretations of pattern identification and reasoning from evidence, their reflections and insights did not, for the most part, lead to actionable understandings. Our results have implications for implementing activity monitor technologies and practices in science education, particularly in regard to student meaning and motivation.
Feminist news media researchers have long contended that masculine news values shape journalists' quotidian decisions about what is newsworthy. As a result, it is argued, topics and issues ...traditionally regarded as primarily of interest and relevance to women are routinely marginalised in the news, while men's views and voices are given privileged space. When women do show up in the news, it is often as "eye candy," thus reinforcing women's value as sources of visual pleasure rather than residing in the content of their views. To date, evidence to support such claims has tended to be based on small-scale, manual analyses of news content. In this article, we report on findings from our large-scale, data-driven study of gender representation in online English language news media. We analysed both words and images so as to give a broader picture of how gender is represented in online news. The corpus of news content examined consists of 2,353,652 articles collected over a period of six months from more than 950 different news outlets. From this initial dataset, we extracted 2,171,239 references to named persons and 1,376,824 images resolving the gender of names and faces using automated computational methods. We found that males were represented more often than females in both images and text, but in proportions that changed across topics, news outlets and mode. Moreover, the proportion of females was consistently higher in images than in text, for virtually all topics and news outlets; women were more likely to be represented visually than they were mentioned as a news actor or source. Our large-scale, data-driven analysis offers important empirical evidence of macroscopic patterns in news content concerning the way men and women are represented.
Few clinically validated biomarkers of ASD exist which can rapidly, accurately, and objectively identify autism during the first years of life and be used to support optimized treatment outcomes and ...advances in precision medicine. As such, the goal of the present study was to leverage both simple and computationally-advanced approaches to validate an eye-tracking measure of social attention preference, the GeoPref Test, among 1,863 ASD, delayed, or typical toddlers (12-48 months) referred from the community or general population via a primary care universal screening program. Toddlers participated in diagnostic and psychometric evaluations and the GeoPref Test: a 1-min movie containing side-by-side dynamic social and geometric images. Following testing, diagnosis was denoted as ASD, ASD features, LD, GDD, Other, typical sibling of ASD proband, or typical. Relative to other diagnostic groups, ASD toddlers exhibited the highest levels of visual attention towards geometric images and those with especially high fixation levels exhibited poor clinical profiles. Using the 69% fixation threshold, the GeoPref Test had 98% specificity, 17% sensitivity, 81% PPV, and 65% NPV. Sensitivity increased to 33% when saccades were included, with comparable validity across sex, ethnicity, or race. The GeoPref Test was also highly reliable up to 24 months following the initial test. Finally, fixation levels among twins concordant for ASD were significantly correlated, indicating that GeoPref Test performance may be genetically driven. As the GeoPref Test yields few false positives (~ 2%) and is equally valid across demographic categories, the current findings highlight the ability of the GeoPref Test to rapidly and accurately detect autism before the 2nd birthday in a subset of children and serve as a biomarker for a unique ASD subtype in clinical trials.
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