Developmental Characteristics Of Sensory In Infants With High Risk Autism Spectrum Disorders

Object: To dynamically observe the development characteristics of sensory(especially in pain)of infants with High-risk Autism Spectrum Disorder(HR-ASD)(whose symptoms meet the diagnosis of ASD but are younger than 24 months old or siblings of ASD),and to further explore the gender differences in these sensory characteristics and the relationship between sensory characteristics and the core symptoms of ASD.Methods: Study 1: the sensory characteristics of HR-ASD infants and their relationship with clinical symptoms From December 2018 to December 2019,39 HR-ASD aged 0 to 23 months were consecutive recruited from outpatient clinic of Child Mental Health Research Center of Nanjing Brain Hospital affiliated to Nanjing Medical University,and their sensory characteristics were evaluated by the Infant/Toddler Sensory Profile(ITSP).All subjects were followed up for 24 months,the diagnosis assessment was conducted by Autism Diagnostic Observation Schedule(ADOS)and two senior children psychiatrist’s re-diagnosis according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders.fifth edition(DSM-5).All 39 subjects were diagnosed with ASD and their development level were assessed by Gesell Development Scale.HR-ASD was divided into typical or atypical(high or low frequency)in four quadrants(hyporesponsiveness,sensory seeking,hyperresponsiveness and sensation avoiding)according to the qualitative results of ITSP.Person correlation analysis was used to analyze the association between scores of ITSP and ADOS as well as developmental level.Study 2: developmental characteristics of sensory in infants with siblings of ASD From Dec 2018 to Dec 2019,33 siblings of ASD aged from 0 to 12 months were consecutive recruited from outpatient clinic of Child Mental Health Research Center of Nanjing Brain Hospital affiliated to Nanjing Medical University,Gesell Development Scale was used to assess the developmental level of siblings of ASD.At 3 months,6 months,9 months and 12 months of age,ITSP was used to assess sensory characteristics,and at 6 months of age,the pain perception and emotion regulation skills were measured by vicarious pain videotape.According to the qualitative results of ITSP across different ages,siblings of ASD were divided into typical or atypical(high or low frequency)in the four quadrants of hyporesponsiveness,sensory seeking,hyperresponsiveness and sensation avoiding,and then the General Linear Model(GLM)was used to describe the trajectory of ITSP scores from 6 to 12 months.Observe XT 12.0 was used to code pain perception frequency and the duration and frequency of emotion regulation behavior toward the caregiver(positive,neutral and negative)and negative emotion regulation behavior not toward caregiver,then explore the difference between male and female siblings of ASD in these behaviors.Results: Study 1: the sensory characteristics of HR-ASD infants and their relationship with clinical symptoms(1)Among the four sub-quadrants of ITSP,hyporesponsiveness was the most common atypical quadrant(84.62%),followed by sensation avoiding(58.97%),sensory seeking(48.72%)and hyperresponsiveness(25.64%).More than 80% of siblings of ASD were characterized as atypical in two or more sensory quadrant.(2)There was a significant positive correlation between hyporesponsiveness and personal-social in ASD group(r=0.39,p=0.01),and there was a significant positive correlation between hyperresponsiveness and gross motor(r=0.32,p=0.05)and fine motor(r=0.33,p=0.04).Study 2: developmental characteristics of sensory in infants with siblings of ASD(1)Among the four sub-quadrants of ITSP,the number of atypical in the field ofhyporesponsiveness was the largest(87.88%),followed by sensory Seeking(66.67%),hyperresponsiveness(54.55%)and sensation avoiding(45.45%),and more than 80% of siblings of ASD were characterized as atypical in two or more sensory quadrant.(2)siblings of ASD showed differences in each sensory quadrant(all p=0.00)between6 months and 9 months,and no difference was shown between 9 months and 12 months(hyporesponsiveness: p=1.00;sensory seeking: p=0.80,hyperresponsiveness: p=0.14;sensation avoiding: p=0.05).But the developmental trajectories are different in four quadrants.In the quadrants of hyporesponsiveness and hyperresponsiveness,the trend of decline was observed in 6~9 months,while the trend of increase was observed in the quadrants of sensory seeking and sensation avoiding.(3)At 6 months,there was no difference in pain perception between male siblings of ASD and female siblings of ASD,but in terms of the duration(p=0.02)and frequency(p=0.00)of neutral emotional regulation toward caregiver,male siblings of ASD was significantly lower than female siblings of ASD.Conclusion: 1.Atypical in sensory is common in HR-ASD,and 80% of HR-ASD showed more than one sensory quadrant abnormalities.At the same time,characteristics of sensory quadrant of siblings of HR-ASD change with age.2.At 6 months,the emotion regulation behaviors of male siblings of ASD are different with female siblings of ASD when facing a visual pain.3.sensory symptoms in infancy were correlated with the individual-social and motor skills in children who later received diagnosis of ASD,which is worthy to further research.