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The present study examined language trajectories and placement outcomes for children with autism spectrum disorder (ASD) receiving early intensive behavioral intervention (EIBI). Language measures were collected at baseline and 6, 12, 18, 24, and 36 months or until exit from EIBI in 131 children with ASD. Growth models estimated overall and subgroup language trajectories. Overall, children receiving EIBI showed substantial increases in language relative to normative expectations. Earlier age at EIBI start, higher baseline cognitive function, and lower baseline ASD severity predicted better language trajectories. Although there was significant variability in language trajectories and educational outcomes, most children showed significant increases in language scores, relative to normative expectations. Additional research, in more representative samples, is needed to understand this variability.

Background: Language assessment is a key element of evaluations of children and adolescents with neurodevelopmental disorders (NDDs). The present study examined the validity of a gaze-based recepti...

The primary objectives of this study were to evaluate the structure and age-related stability of social attention in English and Arabic-speaking youth and to compare social attention between children with autism spectrum disorder (ASD), other developmental disabilities (DD), and typically-developing controls. Eye-tracking data were collected from US (N = 270) and Qatari (N = 242) youth ages 1-17, including children evaluated for possible ASD. Participants viewed 44 stimuli from seven social paradigms. Fixation was computed for areas of interest within each stimulus. Latent variable models examined the structure of social attention. Generalized estimating equation models examined the effect of age, sex, culture, and diagnostic group on social attention. The best-fitting model included a general social attention factor and six specific factors. Cultural differences in social attention were minimal and social attention was stable across age (r = 0.03), but females showed significantly greater social attention than males (d = 0.28). Social attention was weaker in DD (d = -0.17) and lowest in ASD (d = -0.38) relative to controls. Differences were of sufficient magnitude across areas-of-interest to reliably differentiate DD from controls (AUC = 0.80) and ASD-only from all other cases (AUC = 0.76). A social attention dimension that represents an early-life preference for socially salient information was identified. This preference was cross-culturally consistent and stable across development but stronger in females and weaker in DD, especially ASD. Given rapid and easy-to-collect remote eye tracking administration, social attention measurement may be useful for developmental monitoring. Acquisition of population norms, analogous to height/weight/head circumference, might enhance early screening and tracking of neurodevelopment. LAY SUMMARY: This research found that social attention is a single dimension of behavior that represents a strong preference for social stimuli, is consistent across cultures, stable across age, and stronger in females. Children with developmental disabilities had lower levels of social attention than neurotypical children and children with autism spectrum disorder had the lowest levels of social attention.

The present study examined language trajectories and placement outcomes for children with autism spectrum disorder (ASD) receiving early intensive behavioral intervention (EIBI). Language measures were collected at baseline and 6, 12, 18, 24, and 36 months or until exit from EIBI in 131 children with ASD. Growth models estimated overall and subgroup language trajectories. Overall, children receiving EIBI showed substantial increases in language relative to normative expectations. Earlier age at EIBI start, higher baseline cognitive function, and lower baseline ASD severity predicted better language trajectories. Although there was significant variability in language trajectories and educational outcomes, most children showed significant increases in language scores, relative to normative expectations. Additional research, in more representative samples, is needed to understand this variability.

Background The ability to quantitatively analyze how we look at a face and determine if this changes following facial surgery should be of interest to the plastic surgeon. Eye tracking technology (ETT) provides the ability to record where observers fixate when viewing a facial image, enabling quantitative data to be obtained comparing pre- and postoperative changes. Objectives The authors sought to investigate ETT as a novel outcome assessment tool, determining if facial rejuvenation surgery shifts attention away from the prominent signs of aging, and if so, where this attention shifts. Methods Twenty-five volunteers viewed 32 randomized frontal, oblique, and lateral images of 11 patients pre- and post-facelift. An eye movement monitoring system recorded the observer’s eye position, net dwell time, fixation count, fixation time, and revisits into predefined areas of interest. Data were grouped and analyzed by angle and areas of interest. Paired t tests were employed to detect significant differences in pre- and post-images. Results On frontal images, less dwell time, fixations, and revisits were noted on the bottom third, forehead, perioral region, and neck (P Conclusions ETT provides quantitative data post-facial rejuvenation. Facial aesthetic surgery does alter where observers look when viewing a face, decreasing the time spent inspecting the prominent signs of aging.

OBJECTIVE: The primary aim of this study was to develop and validate eye tracking-based measures for estimating autism spectrum disorder (ASD) risk and quantifying autism symptom levels. METHOD: Eye tracking data were collected from youth during an initial evaluation visit, with administrators blinded to all clinical information. Consensus diagnoses were given by the multidisciplinary team. Participants viewed a 5- minute video that included 44 dynamic stimuli from 7 distinct paradigms while gaze was recorded. Gaze metrics were computed for temporally-defined regions-of-interest. Autism risk and symptom indices aggregated gaze measures showing significant bivariate relationships with ASD diagnosis and Autism Diagnostic Observation Schedule 2 (ADOS-2) symptom severity levels in a training sample (75%, n=150). Receiver operating characteristic curve analysis and non-parametric correlations were used to cross-validate findings in a test sample (25%; n=51). RESULTS: Most children (n=201, 92%) completed a valid eye tracking assessment (ages 1.6–17.6; 80% male; ASD n=91, non-ASD n=110). In the test sub-sample, the autism risk index had high accuracy for ASD diagnosis (area under the curve [AUC]=.86, 95%CIs=.75-.95), while the autism symptom index was strongly associated with ADOS-2 total severity scores (r=.41, p.001). CONCLUSION: Eye tracking measures appear to be useful quantitative, objective measures of ASD risk and autism symptom levels. If independently replicated and scaled for clinical use, eye tracking-based measures could be used to inform clinical judgment regarding ASD identification and to track autism symptom levels.

This preliminary study investigated the tolerability and efficacy of a novel mattress technology-the Sound-To-Sleep (STS) system-in the treatment of sleep problems in children with autism.After screening, 45 children, ages 2.5 to 12.9 years, were randomized to order of mattress technology use (On-Off vs. Off-On). Treatment conditions (On vs. Off) lasted two weeks with immediate crossover. Tolerability, including study discontinuation and parent-report of mattress tolerance and ease of use, was tracked throughout the study. Efficacy assessments were obtained at baseline, prior to crossover, and end of study and included measures of autism traits, other psychopathology symptoms, sensory abnormalities, communication difficulties, quality of life, sleep diary parameters, and single-blinded actigraphy-derived sleep parameters. Statistical analyses evaluated differences in tolerability and efficacy when the STS system was on versus off.STS system use was well tolerated (n = 2, 4.4% dropout) and resulted in parent-reported sleep quality improvements (STS off mean = 4.3, 95% CI = 4.05-4.54 vs. on mean = 4.9, 95%CI = 4.67-5.14). The technology was described by parents as very easy to use and child tolerance was rated as good. Parent-diary outcomes indicated improvements in falling asleep and reduced daytime challenging behavior. Actigraphy-derived sleep parameters indicated improved sleep duration and sleep efficiency. Improvements in child and family quality of life were identified on parent questionnaires.A future large sample phase 2 trial of the STS system is warranted and would benefit from extended study duration, an objective primary efficacy outcome, and careful attention to methodological issues that promote compliance with the intervention and study procedures.

Abnormal eye gaze is a hallmark characteristic of autism spectrum disorder (ASD), and numerous studies have identified abnormal attention patterns in ASD. The primary aim of the present study was to create an objective, eye tracking-based autism risk index.In initial and replication studies, children were recruited after referral for comprehensive multidisciplinary evaluation of ASD and subsequently grouped by clinical consensus diagnosis (ASD n = 25/15, non-ASD n = 20/19 for initial/replication samples). Remote eye tracking was blinded to diagnosis and included multiple stimuli. Dwell times were recorded to each a priori-defined region of interest (ROI) and averaged across ROIs to create an autism risk index. Receiver operating characteristic curve analyses examined classification accuracy. Correlations with clinical measures evaluated whether the autism risk index was associated with autism symptom severity independent of language ability.In both samples, the autism risk index had high diagnostic accuracy (area under the curve [AUC] = 0.91 and 0.85, 95% CIs = 0.81-0.98 and 0.71-0.96), was strongly associated with Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) severity scores (r = 0.58 and 0.59, p .001), and not significantly correlated with language ability (r ≤| -0.28|, p.095).The autism risk index may be a useful quantitative and objective measure of risk for autism in at-risk settings. Future research in larger samples is needed to cross-validate these findings. If validated and scaled for clinical use, this measure could inform clinical judgment regarding ASD diagnosis and track symptom improvements.

Objective Numerous studies have identified abnormal gaze in individuals with autism. Yet only a limited number of findings have been replicated, the magnitude of effects is unclear, and the pattern of gaze differences across stimuli remains poorly understood. To address these gaps, we conducted a comprehensive meta-analysis of autism eye tracking studies. Method PubMed and manual search of 1,132 publications were used to identify studies comparing looking behavior to social and/or nonsocial stimuli between individuals with autism and controls. Sample characteristics, eye tracking methods, stimulus features, and regions-of-interest (ROI) were coded for each comparison within each study. Multivariate mixed-effects meta-regression analyses examined the impact of study methodology, stimulus features, and ROI on effect sizes derived from comparisons using gaze fixation metrics. Results The search revealed 122 independent studies with 1,155 comparisons. Estimated effect sizes tended to be small-to-medium, but varied substantially across stimuli and ROI. Overall, nonsocial ROIs yielded larger effect sizes than social ROIs; however, eye and whole face regions from stimuli with human interaction produced the largest effects (Hedge's g=.47 and .50, respectively). Studies with weaker study designs/reporting yielded larger effects, but key effects remained significant and medium-sized, even for high-rigor designs. Conclusion Individuals with autism show a reliable pattern of gaze abnormalities that suggests a basic problem with selecting socially-relevant versus irrelevant information for attention and that is persistent across age and worsens during perception of human interactions. Aggregation of gaze abnormalities across stimuli and ROI could yield clinically useful risk assessment and quantitative, objective outcome measures.