Quantifying latent social motivation and its associations with joint attention and language in infants at high and low likelihood for autism spectrum disorder

Social motivation—the psychobiological predisposition for social orienting, seeking social contact, and maintaining social interaction—manifests in early infancy and is hypothesized to be foundational for social communication development in typical and atypical populations. However, the lack of infant social-motivation measures has hindered delineation of associations between infant social motivation, other early-arising social abilities such as joint attention, and language outcomes. To investigate how infant social motivation contributes to joint attention and language, this study utilizes a mixed longitudinal sample of 741 infants at high (HL = 515) and low (LL = 226) likelihood for ASD. Using moderated nonlinear factor analysis (MNLFA), we incorporated items from parent-report measures to establish a novel latent factor model of infant social motivation that exhibits measurement invariance by age, sex, and familial ASD likelihood. We then examined developmental associations between 6- and 12-month social motivation, joint attention at 12–15 months, and language at 24 months of age. On average, greater social-motivation growth from 6–12 months was associated with greater initiating joint attention (IJA) and trend-level increases in sophistication of responding to joint attention (RJA). IJA and RJA were both positively associated with 24-month language abilities. There were no additional associations between social motivation and future language in our path model. These findings substantiate a novel, theoretically driven approach to modeling social motivation and suggest a developmental cascade through which social motivation impacts other foundational skills. These findings have implications for the timing and nature of intervention targets to support social communication development in infancy.

Highlights

• We describe a novel, theoretically based model of infant social motivation wherein multiple parent-reported indicators contribute to a unitary latent social-motivation factor.
• Analyses revealed social-motivation factor scores exhibited measurement invariance for a longitudinal sample of infants at high and low familial ASD likelihood.
• Social-motivation growth from ages 6–12 months is associated with better 12−15-month joint attention abilities, which in turn are associated with greater 24-month language skills.
• Findings inform timing and targets of potential interventions to support healthy social communication in the first year of life.

     

诊断中的异化与异化的诊断——1例误诊病例的反思

随着诊断技术的日新月异,极大地拓展了临床医师对疾病的认识,但同时也限制了医师的临床思维,形成诊断过程中的"异化"现象。本文以1例患者的误诊过程为例,说明诊断中的异化现象及其对诊断的影响。为减少误诊,医师必须回到"人"的位置,避免成为医疗技术的"奴隶"。     

国内外药品不合理使用的类型、程度及原因分析

不合理用药是在全世界所有国家都存在的问题,已经日益引起各国关注,导致不合理用药主要原因是药品供需双方面的.本文通过文献分析,综述了国内外合理用药促进措施以及目前开展的关于不合理用药的研究,从供需双方分析了不合理用药的类型,程度以及其影响因素.     

Reliable change in neuropsychological test scores is associated with brain atrophy in older adults

The reliable change index (RCI) is a commonly used method for interpreting change in neuropsychological test scores over time. However, the RCI is a psychometric method that, to date, has not been validated against neuroanatomical changes. Longitudinal neuroimaging and neuropsychological data from baseline and one-year follow-up visits were retrieved from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The RCI was used to identify participants showing reliable decline on memory (ADNI-Mem; N = 450) and executive functioning (ADNI-EF; N = 456) factor scores. For each factor score, two groups (reliable change vs. no reliable change) were matched on potential baseline confounding variables. Longitudinal neuroanatomical data were analysed using tensor-based morphometry. Analysis revealed that reliable change on ADNI-Mem was associated with atrophy in the medial temporal cortex, limbic cortex, temporal lobe and some regions of the parietal lobe. Similar atrophy patterns were found for reliable change on ADNI-EF, except that atrophy extended to the frontal lobe and the atrophy was more extensive and of higher magnitude. The current study not only validates clinical usage of the RCI with neuroanatomical evidence of associated underlying brain change but also suggests patterns of likely brain atrophy when reliable cognitive decline is detected.