Girls at Risk for Autism Pay More Attention to Social Cues

Infant girls at risk for autism pay more attention to social cues in faces than infant boys, according to a Yale School of Medicine study — the first one known to prospectively examine sex-related social differences in at-risk infants.

This difference in observational skills could help protect female siblings of children with autism from developing the disorder themselves, according to lead author Katarzyna Chawarska, associate professor in the Yale Child Study Center and in the Department of Pediatrics. The findings are published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Chawarska and her colleagues measured social attention in 101 infants between the ages of 6 and 12 months who have older siblings with autism. The team also studied 61 infants with no risk of autism. Chawarska said high-risk siblings are about 15 to 20 times more likely to have autism than those without a history of autism in the family.

The infants were all shown a video of a woman smiling and cooing at them, while she was doing other activities like pointing to toys in different parts of the screen, and preparing a sandwich. The team tracked where the infants focused their gazes, and for how long.

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Infant girls at risk for autism pay more attention to social cues in faces than infant boys. Credit: Chawarska Lab / Yale School of Medicine.

“We found that the girls in the high-risk group displayed more attention to people and their faces than all other infants,” said Chawarska, who is also director of the Early Social Cognition Laboratory at Yale. “This increased access to social experiences during a highly formative developmental period predicted fewer social impairments at 2 years of age. It is important to note however, that this may not prevent ASD in high-risk females, but could mitigate the severity of autism symptoms.”

Chawarska’s lab is now pursuing several leads they hope will help reveal the mechanisms underlying this attentional advantage in girls.

About this autism research

Other authors on the study include Suzanne Macari, Kelly Powell, Lauren DiNicola, and Frederick Shic.

Funding: The study was funded by the National Institute of Child Health and Development, P01 HD003008, Project 1, National Institutes of Mental Health R01 MH087554, and the SFARI Grant 187398. An author on the study also receives funding from the Yale Clinical and Translational Science Award (CTSA) grant from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health.

Source: Karen N. Peart – Yale
Image Source: The image is credited to Chawarska Lab / Yale School of Medicine.
Original Research: Abstract for “Enhanced Social Attention in Female Infant Siblings at Risk for Autism ” by Katarzyna Chawarska, PhD, Suzanne Macari, PhD, Kelly Powell, PhD, Lauren DiNicola, BS, and Frederick Shic, PhD in Journal of the American Academy of Child & Adolescent Psychiatry. Published online December 17 2015 doi:10.1016/j.jaac.2015.11.016


Abstract

Enhanced Social Attention in Female Infant Siblings at Risk for Autism

Objective

Sexual dimorphism in autism spectrum disorders (ASD) is a well-recognized but poorly understood phenomenon. Females are four times less likely to be diagnosed with ASD than males and, when diagnosed, are more likely to exhibit comorbid anxiety symptoms. One of the key phenotypic features of ASD is atypical attention to socially relevant stimuli. Eye-tracking studies indicate atypical patterns of spontaneous social orienting during the prodromal and early syndromic stages of ASD. However, there have been no studies evaluating sex differences in early social orienting and their potential contribution to later outcomes.

Method

We examined sex differences in social orienting in 6-, 9-, and 12-month-old infants at high genetic risk for ASD (n = 101) and in low-risk controls (n = 61), focusing on neurobehavioral measures of function across a spectrum of autism risk.

Results

Results suggest that, between 6 and 12 months of age, a period highly consequential for the development of nonverbal social engagement competencies, high-risk females show enhanced attention to social targets, including faces, compared to both high-risk males and low-risk males and females. Greater attention to social targets in high-risk infants was associated with less severe social impairments at 2 years.

Conclusion

The results suggest an alternative expression of autism risk in females, which manifests in infancy as increased attention toward socially relevant stimuli. This increased attention may serve as a female protective factor against ASD by providing increased access to social experiences in early development.

This article is discussed in an editorial by Drs. Somer L. Bishop, Jeremy Veenstra-VanderWeele, and Stephan J. Sanders on page xx.

Supplemental material cited in this article is available online.

This article was reviewed under and accepted by associate editor James J. Hudziak, MD.

The study was supported by the National Institute of Child Health and Development, P01 HD003008, Project 1 (K.C.), National Institutes of Mental Health R01 MH087554 (K.C.), and the Simons Foundation (187398, Ami Klin).

The authors thank Gabriella Greco, BA, Lilli Flink, BA, Sharlene Lansiquot, BA, Carla Wall, BA, Elizabeth Kim, PhD, and Quan Wang, PhD, of Yale University School of Medicine, for assistance in data collection and manuscript preparation. The authors wish to express their appreciation to the families and their children for their participation.

Drs. Chawarska and Shic served as the statistical experts for this research.

K.C., S.M., and F.S. developed the initial idea and design of the study. K.C. and F.S. had full access to the data and take responsibility for the integrity of the data. K.C. performed statistical analysis and takes responsibility for the accuracy of the data analysis. S.M. and K.P. conducted and supervised participant characterization. F.S. supervised technological development and technical aspects of experimental procedure, data acquisition, and processing. L.D. contributed to eye tracking data collection and manuscript preparation. K.C. wrote the manuscript.

Disclosure: Dr. Shic has received research funding from Hoffmann-La Roche Ltd and Janssen Research and Development, LLC. Drs. Chawarska, Macari, Powell, and Ms. DiNicola report no biomedical financial interests or potential conflicts of interest.

“Enhanced Social Attention in Female Infant Siblings at Risk for Autism ” by Katarzyna Chawarska, PhD, Suzanne Macari, PhD, Kelly Powell, PhD, Lauren DiNicola, BS, and Frederick Shic, PhD in Journal of the American Academy of Child & Adolescent Psychiatry. Published online December 17 2015 doi:10.1016/j.jaac.2015.11.016

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