2016 Gatlinburg Conference Poster PS-35

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2016 Gatlinburg Conference Poster

PS-35

Title: Attention Shifts and Disengagement of Attention in Infants at High Risk for Autism Spectrum Disorders

Authors: Debra Reisinger, Alexis Brewe, Jane Roberts

Introduction: Attention control is a foundational developmental skill that emerges and develops across infancy with associations to social and non-social outcomes across typical and clinical populations. Evidence indicates that developmental changes in visual attention between 6 to 12 months-of-age predict later autism spectrum diagnoses (ASD; Ibanez et al., 2008). Infants with fragile X syndrome (FXS) are at high risk for developing ASD, as are infants with an older sibling diagnosed with ASD (ASIBs).

Investigating early deficits in visual attention in infants at high risk for ASD can help characterize the infant phenotype of FXS and

ASIBs and serve as a potential prognostic indicator of ASD risk. Our overarching research aim focused on characterizing the relationship of initial latency to visually disengage from a stimulus and frequency in shifts of visual attention across groups at high risk for developing ASD at 9, 12 and 24 months of age and the potential predictive value of these attentional control indicators to ASD severity at 24 months.

Methods: Participants included infant males with FXS (n=16), infant males with an older sibling with autism (ASIBs; n=9), and typically developing infant males (TD; n=15) assessed at 9, 12, and 24 months of age. A toy play epoch from the Laboratory

Temperament Assessment Battery (LabTAB; Goldsmith & Rothbart, 1996) was used to measure initial latency to disengage attention from the toy and frequency of visual shifts in attention to the stimuli (e.g., the number of shifts away from and back to the stimulus during the 3 minute task). Behaviors were coded offline with a kappa of > 0.80 using Observer XT 10.5. The Mullen was utilized to control for developmental levels, and the Autism Diagnostic Observation Schedule-2 was utilized to obtain an autism severity score as the 24-month outcome.

Results: Developmental level was included in all models. Regression analyses were conducted to examine if latency to disengage predicted autism severity at 24 months of age. At 9 months, there were no main or interaction effects (F(4,23)=2.24, p=0.10, r2=0.15). At 12 months, a main effect of group (B=-0.64, SE=0.27, p=0.03) was found indicating more severe ASD features were associated with ASIB infants (r2=0.29). At 24 months, a trend was indicated suggesting increased latency to disengage was associated with more severe ASD features in FXS and ASIB infants (B=-0.64, SE=0.27, p=0.08, r2=0.62). Additional regression analyses were conducted to examine if attention shifts at 9, 12 or 24 months predicted autism severity. At 9 months, decreased attention shifts predicted elevated ASD features at 24 months (B=-0.18, SE=0.08, p=0.03, r2=0.48). At 12 months, the overall model was significant but no specific effects were found between group and attention shifts in predicting autism severity

(F(4,28)=3.78, p=0.02, r2=0.35). At 24 months, a trend was suggested with decreased attention shifts predicting elevated ASD features for the FXS and ASIB groups (B=0.36, SE=0.02, p=0.08, r2=0.70). Additional participants and hierarchical linear modeling will be added by final conference presentation.

Discussion: Our results support a relationship between visual attention across infancy and the emergence of autism symptoms at 24-months-of-age in FXS and ASIBs. These relationships appear primarily rooted in increased latency to disengage and decreased attention shifting that potentially reflects "sticky attention". These relationships appear to emerge early with medium to large effects that strengthen over time and are present by 24 months of age. These findings suggest that atypical visual attention may be a phenotypic feature for both FXS and ASIBs and highlight the potential value of visual attention as a prognostic indicator of autism risk in these two populations.

References/Citations:

• Ibanez, L. V., Messinger, D. S., Newell, L., Lambert, B., & Sheskin, M. (2008). Visual disengagement in the infant siblings of children with an autism spectrum disorder (ASD). Autism, 12(5), 473-485.

• Goldsmith, H. H., & Rothbart, M. K. (1996). The laboratory temperament assessment battery. Madison: University of

Wisconsin, Department of Psychology.Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649-655.

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