Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Paediatr Perinat Epidemiol. 2021 Mar;35(2):247-256. doi: 10.1111/ppe.12723. Epub 2020 Sep 19.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder typically diagnosed after the second year of life; however, differences in brain structure and function associated with ASD have been ascertained in early infancy. Identifying behavioural markers of ASD risk in early infancy has the potential to facilitate early detection and intervention.
We examined associations between infant behaviour and adolescent behaviours associated with ASD.
Analyses leveraged data available on 370 participants from the New Bedford Cohort, a sociodemographically diverse prospective birth cohort of children born from 1993 to 1998 to mothers residing near the New Bedford Harbor Superfund site in Massachusetts. Longitudinal assessments were used to examine the associations between behaviours when children were approximately 2 weeks old (measured by the Neonatal Behavioral Assessment Scale [NBAS]), and subsequent maladaptive behaviours associated with ASD at approximately 15 years old [measured by the Behavior Assessment System for Children, 2nd Edition-Teacher Rating Scale (BASC-2 TRS) scores which are standardised to a mean (SD) of 50 (10)].
Poorer performance on select individual items and cluster scales of the NBAS was associated with an increase in behaviours associated with ASD in adolescents. Associations were strongest for neonatal measures of self-regulation, response to auditory input, and autonomic nervous system regulation. For example, in covariate-adjusted models, infants with Regulation of State NBAS cluster scores in the lowest tertile (poorest performance) compared to infants with scores in the higher two tertiles had adolescent BASC-2 TRS Developmental Social Disorders T-scores that were 2.9 points higher (95% CI: 0.8, 4.9), indicating more behaviours associated with ASD.
The NBAS is an established and accessible instrument that assesses a broad range of behaviours in very young infants, and may be a useful tool for newborn assessments of developmental risk, including risk of ASD-associated behaviours.
自闭症谱系障碍（ASD）是一种神经发育障碍，通常在生命的第二年之后被诊断；然而，与 ASD 相关的大脑结构和功能差异在婴儿早期就已确定。在婴儿早期识别 ASD 风险的行为标志物有可能促进早期发现和干预。
我们研究了婴儿行为与青少年 ASD 相关行为之间的关联。
分析利用了马萨诸塞州新贝德福德港附近出生的儿童的新贝德福德队列（一个社会人口统计学多样化的前瞻性出生队列）370 名参与者的数据。使用纵向评估来研究当孩子大约 2 周大时（通过新生儿行为评估量表 [NBAS] 测量）的行为与大约 15 岁时与 ASD 相关的适应不良行为之间的关联[通过行为评估系统为儿童，第 2 版-教师评定量表（BASC-2 TRS）评分来衡量，该评分以 50（10）的平均值（SD）标准化]。
NBAS 中个别项目和簇量表的表现较差与青少年 ASD 相关行为的增加有关。与新生儿自我调节、听觉输入反应和自主神经系统调节相关的测量值的关联最强。例如，在调整协变量的模型中，NBAS 中状态调节簇评分最低 tertile（表现最差）的婴儿与评分较高的两个 tertile 的婴儿相比，青少年 BASC-2 TRS 发展性社会障碍 T 评分高 2.9 分（95%CI：0.8，4.9），表明 ASD 相关行为更多。
NBAS 是一种成熟且易于使用的工具，可评估非常年幼婴儿的广泛行为，可能是新生儿发育风险评估（包括 ASD 相关行为风险）的有用工具。
