Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder.

IMPORTANCE: Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. OBJECTIVE: To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. DESIGN: Observational cohort longitudinal design using blinded video analysis. PARTICIPANTS: Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. RESULTS: Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. CONCLUSIONS AND RELEVANCE: Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.

Education on the consequences of traumatic brain injury for children and adolescents with TBI and families/caregivers: a systematic scoping review.

OBJECTIVE(S): To examine the breadth of education or training on the consequences of traumatic brain injury (TBI) for children and adolescents with TBI and their families/caregivers. METHODS: Systematic scoping review of literature published through July 2018 using eight databases and education, training, instruction, and pediatric search terms. Only studies including pediatric participants (age <18) with TBI or their families/caregivers were included. Six independent reviewers worked in pairs to review abstracts and full-text articles independently, and abstracted data using a REDCap database. RESULTS: Forty-two unique studies were included in the review. Based on TBI injury severity, 24 studies included persons with mild TBI (mTBI) and 18 studies focused on moderate/severe TBI. Six studies targeted the education or training provided to children or adolescents with TBI. TBI education was provided primarily in the emergency department or outpatient/community setting. Most studies described TBI education as the main topic of the study or intervention. Educational topics varied, such as managing TBI-related symptoms and behaviors, when to seek care, family issues, and returning to work, school, or play. CONCLUSIONS: The results of this scoping review may guide future research and intervention development to promote the recovery of children and adolescents with TBI.

Early Identification of Sensory Processing Difficulties in High-Risk Infants.

OBJECTIVE: Our objective was to determine the extent to which young children at high risk for sensory processing difficulties differed from those who were at low risk. METHOD: We compared high- versus low-risk young children using standardized measures. High-risk participants had older siblings identified as having sensory processing difficulties after a comprehensive occupational therapy evaluation (n = 13); low-risk participants (n = 16) had typically developing siblings and no family history of sensory or other neurological disorders. RESULTS: High-risk infants scored significantly lower on the Language and Cognitive scales of the Bayley Scales of Infant and Toddler Development-Third Edition. The high-risk group presented with more atypical positions on the Toddler and Infant Motor Evaluation and fewer sensation-seeking behaviors on the Toddler Sensory Profile-2. CONCLUSION: Results suggest that sensory, motor, cognitive, and language dimensions may be associated with sensory processing difficulties. Implications exist for the design of future studies and for early intervention.

Early Indicators of Autism in Infants: Development of the IMES Screening Tool.

We developed the Infant, Motor, and Engagement Scale (IMES) to address the public health goal of early identification of autism spectrum disorder (ASD). The IMES is a screening tool that assesses quality of infants' interaction with people and objects during early play. We aimed to examine the IMES' preliminary psychometric properties and its value in discriminating between infants later diagnosed with ASD and typically developing infants. We used the IMES to score retrospective home videos of 15 male infants, 7 who were later diagnosed with autism. We examined interrater reliability using Cohen's Kappa, internal consistency with Cronbach's alpha and content validity through expert review. Preliminary data support validity and reliability of the IMES for early identification for infants at 6 to 9 months. With further research, the IMES has the potential to identify at risk infants at a young age that may have long-term impact on child and family outcomes.

Flourishing in children with autism spectrum disorders.

Flourishing is an indicator of positive mental health and is important for children's development and well-being. We used variables from the National Survey of Children's Health 2016 as indicators of flourishing (difficulty making friends, is bullied, bullies others, shares ideas with family, argues, finishes tasks, does all homework, shows curiosity, stays calm, and cares about doing well in school) to compare differences in parent perceptions of their children with and without autism spectrum disorder (ASD). We anticipate that these findings will help identify intervention targets to support the well-being of individuals with ASD. Children between 6 and 17 years of age, without intellectual disability, brain injury, cerebral palsy, or Down syndrome were included. Total participants were 34,171 controls (male/female = 17,116/17,155) and 812 with ASD (male/female = 668/144). Factor analysis resulted in three-factor structures (social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08, comparative fit index = 0.92, Tucker-Lewis index = 0.89). The multivariate regression model and propensity score with inverse probability of treatment weighting (PS-IPTW) method revealed that children with ASD had lower scores in the social competence and behavioral control factors compared to the control group (all P < 0.05). However, no significant differences were found in the school motivation factor between the two groups (P > 0.05) in both multivariate regression model and PS-IPTW method. Findings suggest that social competence and behavioral control are indicators of flourishing and are important intervention targets to increase flourishing among children with ASD. Autism Res 2019, 12: 952-966. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Flourishing is an indicator of positive mental health and is important for children's development and well-being. We used variables from The National Survey of Children's Health 2016 to examine differences in parent perceptions of the indicators of flourishing (difficulty making friends, is bullied, bullies others, shares ideas with family, argues, finishes tasks, does all homework, shows curiosity, stays calm, and cares about doing well in school) between children with and without autism spectrum disorders (ASD). We anticipate that this information will help to identify therapeutic targets to support the well-being of individuals with ASD. Children between 6 and 17 years old, without intellectual disability (ID), brain injury (BI), cerebral palsy (CP), or Down syndrome (DS) were included. From the total (N = 50,212), we excluded children under age 6 (n = 14,494), those who once, but do not currently have ASD (n = 81), and those with ID (n = 432), BI (n = 170), CP (n = 35), and DS (n = 17), resulting in 34,983 records used. Total participants, age 6-17 years, were 34,171 controls (male/female = 17,116/17,155) and 812 with ASD (male/female = 668/144). Factor analysis resulted in the identification of three flourishing categories among the indicator variables (social competence, behavioral control, and school motivation). Children with ASD had lower scores in the social competence and behavioral control factors compared to the control group. However, there were no significant differences in the school motivation factor between the two groups. Findings suggest that social competence and behavioral control are indicators of flourishing and are important intervention targets to increase flourishing among children with ASD.

The effect of periodicity on the defect modes of large mode area microstructured fibers.

It is well known that periodic variations in refractive index can be used to create guidance in an optical fiber via photonic bandgap effects. It has also been shown that periodic structure in index-guiding microstructured fibers can lead to the guidance of additional leaky higher-order modes due to bandgap effects. Here we demonstrate that this additional guidance mechanism can have important practical implications in large mode area silica microstructured fibers. We also demonstrate that similar modes can exist when a bandgap is not present and attribute this guidance to a low density of states. Excellent agreement between theoretical predictions and experimental observations is demonstrated. We explore the impact of these additional modes on the practical operation of these fibers and explore ways of minimizing their effects via the fiber geometry.

Single-mode tellurite glass holey fiber with extremely large mode area for infrared nonlinear applications.

We report the fabrication of a large mode area tellurite holey fiber from an extruded preform, with a mode area of 3000microm(2). Robust single-mode guidance at 1.55microm was confirmed by both optical measurement and numerical simulation. The propagation loss was measured as 2.9dB/m at 1.55microm. A broad and flat supercontinuum from 0.9 to 2.5microm with 6mW output was obtained with a 9cm length of this fiber.

Determination of 2D poloidal maps of the intrinsic W density for transport studies in JET-ILW.

The experimental method developed at ASDEX Upgrade for the determination of the intrinsic tungsten (W) density profile coupling data from the soft X-ray (SXR) diagnostic and vacuum-ultra-violet (VUV) spectroscopy has been upgraded for application to JET plasmas. The strong poloidal asymmetries in the SXR emission are modeled assuming a ln ( ϵ ( ρ , R ) / ϵ ( ρ , R 0 ) ) = λ ( ρ ) ( R 2 - R 0 2 ) distribution, where ρ is the flux coordinate, R is the major radius, and λ is the fit parameter. The W density is calculated from the resulting 2D SXR emissivity maps accounting for contributions from a low-Z impurity (typically beryllium) and main ion with the assumption that their contributions are poloidally symmetric. Comparing the result with the independent W concentration measurement of VUV spectroscopy, a recalibration factor for the SXR emissivity is calculated making the method robust against the decrease in the sensitivity of the SXR diodes which has been observed across multiple campaigns. The final 2D W density map is checked for consistency versus the time-evolution of the W concentration measurement from VUV spectroscopy, toroidal rotation measurements from charge exchange recombination spectroscopy, and tomographic reconstructions of bolometry data. The method has been found to be robust for W concentrations above a few 10-5 and in cases where the contributions from other medium-Z impurities such as Ni are negligible.

Microstructured fibers for broadband wavefront filtering in the mid-IR.

The European Space Agency's space-based Darwin mission aims to directly detect extrasolar Earth-like planets using nulling interferometry. However, in order to accomplish this using current optical technology, the interferometer input beams must be filtered to remove local wavefront errors. Although short lengths of single-mode fiber are ideal wavefront filters, Darwin's operating wavelength range of 4 - 20 microm presents real challenges for optical fiber technology. In addition to the fact that step-index fibers only offer acceptable coupling efficiency over about one octave of optical bandwidth, very few suitable materials are transparent within this wavelength range. Microstructured optical fibers offer two unique properties that hold great promise for this application; they can be made from a single-material and offer endlessly single-mode guidance. Here we explore the advantages of using a microstructured fiber as a broadband wavefront filter for 4 - 20 microm.

Square core jacketed air-clad fiber.

We report the fabrication of a highly multi-mode square core jacketed air-clad fiber with a top-hat near-field intensity profile. Using this fiber to deliver Q-switched pulses at 1 mum we have successfully produced square shaped ablation marks in indium tin oxide (ITO) without the use of complex beam shaping optics.

Head lag in infants at risk for autism: a preliminary study.

OBJECTIVE.Poor postural control during pull-to-sit is a predictor of developmental disruption in cerebral palsy and preterm populations but has not been examined in infants at risk for autism. We examined the association between head lag during pull-to-sit at age 6 mo and autism risk status. METHOD.High-risk participants were siblings of children with autism. We studied one sample of 40 high-risk infants prospectively from 6-36 mo and obtained diagnostic classifications of autism or no autism. We conducted a subsequent between-group comparison with a new sample of 20 high-risk and 21 low-risk infants. RESULTS.Head lag was significantly associated with autism spectrum disorder at 36 mo (p = .020) and was more frequently observed in high-risk than in low-risk infants (p = .018). CONCLUSION.Head lag with other alterations in early development may be associated with autism risk and may serve as an early indicator of neurodevelopmental disruption. Results have clinical implications for occupational therapists in early intervention practice.