自闭症早期预警:联合注意和共情的发生发展及影响因素

自闭症在3岁前已经发病,目前对于自闭症儿童的诊断却要到3岁后,滞后性的诊断使得自闭症儿童可能错过最佳干预治疗期。证据显示,在婴幼儿早期,联合注意与共情的发生发展可以作为3岁之前自闭症预警的重要内容。早期联合注意能力发展异常是自闭症言语和社交障碍的重要诱因;而早期共情能力发展的偏离则可能导致自闭症儿童表现出社交障碍和沟通障碍。文章初步描绘出早期联合注意和共情的发生发展轨迹,总结归纳了影响二者早期发生发展的三个重要方面:神经生理、遗传和环境机制。未来的研究应考虑结合分子生物学和神经成像技术,设计更加生态化的联合注意及共情任务,探索自闭症个体联合注意和共情损伤在大脑分子细胞层面的表征状态,从而为自闭症的早期预警提供更加客观的指标。     

空白重叠范式对自闭症儿童的早期预测

摘 要 空白重叠范式是研究视觉注意特征常用的实验范式。自闭症儿童普遍存在注意解离缺陷,空白重叠范式揭示出该群体注意解离存在异常。国外开始重视将该范式用于自闭症的预测,而我国在这方面的研究很少。本文对空白重叠范式的操作程序、基本原理和数据分析等内容进行了系统地介绍,并就空白重叠范式在自闭症婴幼儿预测中的作用、使用时需注意的方法论等问题进行了展望,以期促进空白重叠范式在我国自闭症早期预测中的运用。     

食物线索注意偏向及其神经机制

与其他类型的刺激相比, 个体会优先注意食物相关刺激, 即对食物刺激的注意偏向。对影响食物线索注意偏向个体因素研究的分析发现：(1)在状态因素中, 饥饿以及与自我威胁有关的、唤起强度大的负性情绪对食物线索注意偏向有增强作用, 这在注意加工的早期和晚期都有体现; (2)在特质因素中, 行为研究发现, 相比于体重正常个体和非限制性饮食者, 超重/肥胖个体以及唤起节食目标的成功限制性饮食者没有更强的注意偏向, 但是, ERP研究发现, 在注意加工的早期阶段, 就出现了特质因素对食物线索注意偏向的影响; (3) fMRI研究发现, 对食物线索的注意过程伴随着脑岛、眶额叶皮层等与奖励相关的脑区及视觉注意网络的激活。未来研究需要：(1)从动态角度研究注意偏向, 进一步提高测量的信度; (2)使用专门的范式探究个体因素影响注意偏向的神经机制; (3)严格分离不同状态因素; (4)对被试进行严谨筛选和划分, 做好被试间的对比研究。     

注意线索对自闭特质个体疼痛共情的影响：来自事件相关电位的证据

自闭特质个体在日常生活中表现出共情缺损, 但其程度较自闭症谱系障碍个体低, 并且注意线索和特异性的面孔加工可能会影响他们的共情加工进程。因此, 本研究采用事件相关电位(ERP)技术, 以疼痛面孔图片作为刺激材料, 让自闭特质组和控制组分别完成疼痛判断任务(该任务中被试的注意指向疼痛线索)和吸引力判断任务(该任务中被试的注意不指向疼痛线索)。结果发现, 相比控制组, 自闭特质组在吸引力判断任务中疼痛面孔图片诱发的P3波幅更大, 而在疼痛判断任务中两组没有显著差异。这表明注意线索会影响自闭特质个体对他人疼痛面孔的共情反应, 当自闭特质个体不注意他人面孔的疼痛线索时, 其疼痛共情能力会减弱。     

对威胁刺激的注意偏向：注意定向加速还是注意解除困难？

对威胁刺激的注意偏向普遍存在。注意定向加速和注意解除困难在不同阶段对注意偏向产生影响。威胁刺激属性、呈现时间以及被试特征是重要的调节因素。以杏仁核为核心的杏仁核?前扣带回网络可能是注意定向加速的神经基础, 而以眶额叶为中心的前额叶皮层可能是注意解除的神经基础。未来还需要就注意定向加速与注意解除困难的关系、注意偏向的调节机制以及其神经基础做更深入的研究。     

自闭症谱系障碍个体的社会动机缺陷

自闭症谱系障碍(ASD)是一种源于儿童期的神经发育障碍, 社会交往障碍是其核心特征, 与社会动机缺陷密切相关。社会动机是引导个体社会行为的强大动力, 主要表现为社会定向、社会奖赏和社会维持。现有研究表明, ASD个体的社会动机发展存在缺陷, 他们对社会刺激的注意偏向减少, 不能主动寻求和体会社会互动带来的快乐, 且缺乏维持社会关系的行为策略等。然而, 相关研究结果受到个体特征、环境和实验设计等因素的影响。研究者未来应综合考虑这些影响因素, 加强对ASD个体社会动机理论的整合研究, 以便全面系统地了解ASD个体的社会动机缺陷。     

动词隐含因果语义对汉语高功能自闭症儿童代词加工的影响

个体在利用动词隐含因果语义线索确定代词所指的过程中会结合动词语义特征和语境信息两个方面,已有研究指出自闭症儿童在语言加工过程中无法有效利用语境信息,本研究采用句子理解任务,考察有无语境支持和不同动词类型（主语隐含型和宾语隐含型）四种条件下,汉语高功能自闭症儿童利用动词隐含因果语义信息加工代词的能力。结果显示,（1）汉语高功能自闭症儿童的代词加工表现显著差于典型发展儿童;（2）语境信息可以帮助被试确定代词所指,且对两组被试成绩的提高程度相当。以上结果表明汉语高功能自闭症儿童之所以无法利用动词的隐含因果语义线索确定代词所指的原因可能是他们对该类动词的语义表征存在问题,而非无法利用语境信息。     

动词隐含因果语义对汉语高功能自闭症儿童代词加工的影响

个体在利用动词隐含因果语义线索确定代词所指的过程中会结合动词语义特征和语境信息两个方面,已有研究指出自闭症儿童在语言加工过程中无法有效利用语境信息,本研究采用句子理解任务,考察有无语境支持和不同动词类型（主语隐含型和宾语隐含型）四种条件下,汉语高功能自闭症儿童利用动词隐含因果语义信息加工代词的能力。结果显示,（1）汉语高功能自闭症儿童的代词加工表现显著差于典型发展儿童;（2）语境信息可以帮助被试确定代词所指,且对两组被试成绩的提高程度相当。以上结果表明汉语高功能自闭症儿童之所以无法利用动词的隐含因果语义线索确定代词所指的原因可能是他们对该类动词的语义表征存在问题,而非无法利用语境信息。     

高共情者加工情绪刺激的注意特征及其眼动证据

共情是指个体通过观察、想象或推断他人的情感而产生与之同形的情感体验。本研究采用点探测范式并结合眼动追踪技术,以词语和面孔表情为实验材料,综合探讨了高低共情被试对不同类型刺激材料的注意偏向及具体成分的时间进程特点。结果表明,虽然高低共情被试都对负性刺激（特别是对悲伤面孔）表现出早期注意定向（首次注视到达时间更快）,但只有高共情被试对悲伤面孔的晚期注意维持更长（总注视时间更长）。本研究表明,面孔表情是区分共情特质注意偏向更有效的实验材料;高共情被试对悲伤面孔表情存在注意偏向,这为理解人际间的心灵感知提供了重要的实证依据。     

自闭症儿童能否痊愈?——来自谱系个体“最佳结果”及剩余缺陷研究的证据分析

自闭症谱系障碍预后效果不佳, 通常被认为是一种伴随终生的疾病。不过随着研究的拓展和深入, 部分早期被诊断为自闭症的儿童, 随着年龄增长和相关干预措施的介入, 其认知、适应性等方面均可达到正常发展水平, 并且不再符合自闭症的诊断标准, 即达到了“最佳结果”。但多数个体仍然存在不同程度的剩余缺陷。本文以自闭症预后结果评定和“最佳结果”定义演变为切入点, 分析“最佳结果”个体剩余缺陷的具体表现, 并梳理此类群体的个体特征与结果预测因素, 以期能为自闭症个体的系统干预提供有效依据。     

Additive effects of social and non‐social attention during infancy relate to later autism spectrum disorder

Emerging findings from studies with infants at familial high risk for autism spectrum disorder (ASD), owing to an older sibling with a diagnosis, suggest that those who go on to develop ASD show early impairments in the processing of stimuli with both social and non‐social content. Although ASD is defined by social‐communication impairments and restricted and repetitive behaviours, the majority of cognitive theories of ASD posit a single underlying factor, which over development has secondary effects across domains. This is the first high‐risk study to statistically differentiate theoretical models of the development of ASD in high‐risk siblings using multiple risk factors. We examined the prediction of ASD outcome by attention to social and non‐social stimuli: gaze following and attentional disengagement assessed at 13 months in low‐risk controls and high‐risk ASD infants (who were subsequently diagnosed with ASD at 3 years). When included in the same regression model, these 13‐month measures independently predicted ASD outcome at 3 years of age. The data were best described by an additive model, suggesting that non‐social attention, disengagement, and social attention as evidenced by gaze following, have a cumulative impact on ASD risk. These data argue against cognitive theories of ASD which propose that a single underlying factor has cascading effects across early development leading to an ASD outcome, and support multiple impairment models of ASD that are more consistent with recent genetic and neurobiological evidence.     

Unimpaired attentional disengagement in toddlers with autism spectrum disorder

A prominent hypothesis holds that ‘sticky’ attention early in life in children with autism spectrum disorder (ASD) limits their ability to explore and learn about the world. Under this hypothesis, the core clinical symptoms of ASD – restricted interests, repetitive behaviors and impaired social/communication abilities – could all result from impaired attentional disengagement during development. However, the existence of disengagement deficits in children with ASD is controversial, and a recent study found no deficit in 5‐ to 12‐year‐olds with ASD. Nonetheless, the possibility remains that disengagement is impaired earlier in development in children with ASD, altering their developmental trajectory even if the attentional deficit itself is remediated or compensated for by the time children with ASD reach school age. Here, we tested this possibility by characterizing attentional disengagement in a group of toddlers just diagnosed with ASD (age 21 to 37 months). We found strikingly similar performance between the ASD and age‐matched typically developing (TD) toddlers, and no evidence of impaired attentional disengagement. These results show that even at a young age when the clinical symptoms of ASD are first emerging, disengagement abilities are intact. Sticky attention is not a fundamental characteristic of ASD, and probably does not play a causal role in its etiology.     

孤独症谱系障碍者视觉定向与视觉搜索的特点及神经机制

定向网络是注意网络的重要组成部分, 主要包括视觉定向与视觉搜索两大任务。对于这两大注意任务, 正常个体在神经机制上存在较大的重叠, 然而, 孤独症个体却表现出截然相反的行为证据。研究者从非社会信息的注意视角发现, 一般而言, 在视觉定向上, 孤独症个体注意转移不存在缺陷, 而注意脱离存在困难, 但该结论仍有争议; 在视觉搜索上, 孤独症个体存在视觉搜索优势, 但该优势发生的阶段及原因仍需进一步探究。未来研究应进一步考察孤独症个体在视觉定向任务中左右视野的不对称性、视觉搜索优势的内在机制及两大注意任务之间的相互关系。     

高风险婴儿前瞻性纵向研究与孤独症谱系障碍早期识别

孤独症谱系障碍(Autism Spectrum Disorder, ASD)早期识别有助于早期诊断和早期干预的实施, 对于改善ASD儿童发育结果至关重要。高风险前瞻性纵向研究以高风险婴儿(ASD儿童的年幼同胞, 入组年龄小于12个月)作为主要研究对象, 通过对ASD高风险婴儿(24至36个月之间诊断为ASD的高风险婴儿)的早期发育轨迹的描绘和核心症状早期表现的识别, 为ASD早期识别提供了重要依据。未来可以增加被试数量、延长观察时间并密集观察时间点、关注伴发障碍、综合考虑遗传、环境和文化因素影响, 并结合早期干预研究进行深入探索。未来在中国开展相关研究具有重要的科学价值和临床意义。     

Associations between attentional biases to fearful faces and social-emotional development in infants with and without an older sibling with autism

During the first year of life, infants become increasingly attuned to facial emotion, with heightened sensitivity to faces conveying threat observed by age seven months as illustrated through attentional biases (e.g., slower shifting away from fearful faces). Individual differences in these cognitive attentional biases have been discussed in relation to broader social-emotional functioning, and the current study examines these associations in infants with an older sibling with autism spectrum disorder (ASD), a group with an elevated likelihood of a subsequent ASD diagnosis (ELA; n = 33), and a group of infants with no family history of ASD who are at low likelihood of ASD (LLA; n = 24). All infants completed a task measuring disengagement of attention from faces at 12 months (fearful, happy, neutral), and caregivers completed the Infant-Toddler Social and Emotional Assessment at 12, 18, and/or 24 months. For the full sample, greater fear bias in attention disengagement at 12 months related to more internalizing behaviors at 18 months, and this was driven by the LLA infants. When examining groups separately, findings revealed that LLA with a greater fear bias had more difficult behaviors at 12, 18, and 24 months; in contrast, ELA showed the opposite pattern, and this was most pronounced for ELA who later received an ASD diagnosis. These preliminary group-level findings suggest that heightened sensitivity to fearful faces might serve an adaptive function in children who later receive an ASD diagnosis, but in infants with no family history of ASD, increased biases might reflect a marker of social-emotional difficulties.     

Low-level visual attention and its relation to joint attention in autism spectrum disorder

Visual attention is integral to social interaction and is a critical building block for development in other domains (e.g., language). Furthermore, atypical attention (especially joint attention) is one of the earliest markers of autism spectrum disorder (ASD). The current study assesses low-level visual attention and its relation to social attentional processing in youth with ASD and typically developing (TD) youth, aged 7 to 18 years. The findings indicate difficulty overriding incorrect attentional cues in ASD, particularly with non-social (arrow) cues relative to social (face) cues. The findings also show reduced competition in ASD from cues that remain on-screen. Furthermore, social attention, autism severity, and age were all predictors of competing cue processing. The results suggest that individuals with ASD may be biased towards speeded rather than accurate responding, and further, that reduced engagement with visual information may impede responses to visual attentional cues. Once attention is engaged, individuals with ASD appear to interpret directional cues as meaningful. These findings from a controlled, experimental paradigm were mirrored in results from an ecologically valid measure of social attention. Attentional difficulties may be exacerbated during the complex and dynamic experience of actual social interaction. Implications for intervention are discussed.     

Motor anticipation failure in infants with autism: a retrospective analysis of feeding situations

Previous studies on autism have shown a lack of motor anticipation in children and adults with autism. As part of a programme of research into early detection of autism, we focussed on an everyday situation: spoon-feeding. We hypothesize that an anticipation deficit may be found very early on by observing whether the baby opens his or her mouth in anticipation of the spoon's approach. The study is based on a retrospective analysis from family home movies. Observation of infants later diagnosed with autism or an autism spectrum disorder (ASD) (n = 13) and infants with typical development (n = 14) between 4 and 6 months old show that the autism/ASD group has an early anticipation deficit.     

Influence of the environment on the early development of attentional control

The control of visual attention is key to learning and has a foundational role in the development of self-regulated behavior. Basic attention control skills emerge early in life and show a protracted development along childhood. Prior research suggests that attentional development is influenced by environmental factors in early and late childhood. Although, much less information is available about the impact of the early environment on emerging endogenous attention skills during infancy. In the current study we aimed to test the impact of parental socioeconomic status (SES) and home environment (chaos) in the emerging control of orienting in a sample of typically-developing infants. A group of 142 (73 female) 6-month-old infants were longitudinally tested at 6, 9 (n = 122; 60 female) and 16–18 (n = 91; 50 female) months of age using the gap-overlap paradigm. Median saccade latency (mdSL) and disengagement failure (DF) were computed as dependent variables for both overlap and gap conditions. Also, composite scores for a Disengagement Cost Index (DCI) and Disengagement Failure Index (DFI) were computed considering mdSL and DF of each condition, respectively. Families reported SES and chaos in the first and last follow-up sessions. Using Linear Mixed Models with Maximum Likelihood estimation (ML) we found a longitudinal decrease in mdSL in the gap but not in the overlap condition, while DF decreased with age independently of the experimental condition. Concerning early environmental factors, an SES index, parental occupation and chaos at 6 months were found to show a negative correlation with DFI at 16–18 months, although in the former case it was only marginally significant. Hierarchical regression models implementing ML showed that both SES and chaos at 6 months significantly predicted a lower DFI at 16–18 months. Results show a longitudinal progression of endogenous orienting between infancy and toddlerhood. With age, an increased endogenous control of orienting is displayed in contexts where visual disengagement is facilitated. Visual orienting involving attention disengagement in contexts of visual competition do not show changes with age. Moreover, these attentional mechanisms of endogenous control seem to be modulated by early experiences of the individual with the environment.     

Initiation of joint attention and related visual attention processes in infants with autism spectrum disorder: Literature review

Autism spectrum disorder (ASD) represents a group of neurodevelopmental disabilities that can be difficult to identify before the age of 2 or 3 years, the age when the full range of behavioral symptoms has emerged in most cases. Initiation of joint attention is an important developmental function in which impairments are already observable before the second birthday and can predict children’s ASD symptomatology. In the first part of this review, we summarize results pertaining to retrospective studies of initiation of joint attention in children with ASD and prospective studies of infants at high risk for ASD during the first 2 years, when this behavior is becoming more complex in terms of frequency, quality, and variety. We will also discuss the implications of impairments in dyadic engagement, a precursor of joint attention behavior, for the early development of joint attention. Finally, the early development of initiation of joint attention has been related to specific visual attention mechanisms such as social orienting and visual disengagement. In the second part of this review, we provide an overview of the relationship between those visual attention mechanisms and subsequent social-communication impairments. Clinical and research implications of these findings for both early detection and early intervention will be discussed.