Investigating Biological, Psychological and Social factors of early symptom emergence in ASD and ADHD: A longitudinal 'high-risk' study.

Lead Research Organisation: King's College London
Department Name: Psychology

Abstract

In human development, it is now known that an interaction between biological (genetic risks, brain and neurocognitive development) and environmental factors over the life course affects both typical and atypical developmental trajectories. Understanding the nature of this interplay is essential, particularly in children who are at increased risk of neurodevelopmental disorders.

Autism spectrum disorder (ASD) is a moderate-to-highly heritable disorder (Messinger et al., 2015; Szatmari et al., 2016). ASD and attention deficit hyperactivity disorder (ADHD) have also been found to have high rates of co-occurrence (Russell, Rodgers, Ukoumunne & Ford, 2014). There is research which highlights shared risk factors concerning genetic (Smoller, 2013) and environmental (Ronald, Pennell & Whitehouse, 2011) risks for the disorders, and possible mechanisms of resilience common to those at 'high-risk' for ASD and ADHD (Johnson, 2012).

Given the heritability of the disorders, studying an infant with a first-degree sibling with a diagnosis of ASD or ADHD provides unique insight into the developmental trajectory of the disorders. This can help to identify common and distinct mechanisms leading to the early emergence of symptoms of the two disorders. It can also advance knowledge about subclinical traits in the broader Autism phenotype (BAP) (Ozonoff et al., 2011). These advantages advocate the high-risk sibling design that is being utilised in the British Autism Study of Infant Siblings, Studying Autism and ADHD Risks (BASIS STAARS), under Principal Investigators Professor Mark Johnson and Professor Tony Charman (see http://staars.org).

The current cohort of this phase of BASIS STAARS includes 100 high-risk ASD, 80 high-risk ADHD and 40 low-risk control infants and toddlers. The children are seen in the laboratory at 5, 10, 14, 24 and 36 months, and engage in a range of experimental and behavioural observation assessments. These include eye tracking, EEG, parent-child interaction (PCI), and the Autism Diagnostic Observation Schedule (ADOS), to name a few. During laboratory visits, parents engage in interviews such as the Vineland. Parents are also asked to complete questionnaires that measure infant behaviours, older sibling (proband) symptom levels and the family environment.

Therefore, this project proposes to exploit the high-risk longitudinal design within BASIS STAARS, to investigate the emergence of early symptoms and development of ASD and ADHD. By adopting a multi-disciplinary approach, this research will aim to investigate the biological, psychological and social factors underlying causal mechanisms of ASD and ADHD. Furthermore, this research proposes to investigate the presence of sub-clinical traits by exploring the nature of the BAP in the infant and toddler cohort, other siblings and parents of the probands.

It would be interesting to shed light on areas that are lacking in existing literature with this project. For example, investigating the role of multi-sensory integration in aspects of early social communicative development in high-risk individuals (and how this may differ in ASD and ADHD). Additionally, investigating neurocognitive features that are specific to the development of the respective disorders would be of interest to draw conclusions regarding their high co-occurrence.

In summary, by utilising the aforementioned multi-disciplinary methods, it is possible to explore mechanisms underlying the heterogenous causal factors of ASD and ADHD, as separate and/or co-occurring entities. Furthermore, investigating the nature of these interactions over time will elucidate the underlying factors for resilience to the emergence of clinical traits of the disorders. Insight into the nature of these interactions in early development is important for the progression of early interventions and in order to help identify individuals at greatest risk, whom would benefit most from additional support.

Publications

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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000703/1 01/10/2017 30/09/2027
1917731 Studentship ES/P000703/1 01/10/2017 20/06/2023 Mary Abena Agyapong
 
Description INSAR Diversity Travel Award
Amount $1,000 (USD)
Organisation International Society for Autism Research (INSAR) 
Sector Academic/University
Country Global
Start 05/2020 
End 05/2020
 
Description King's Student Opportunity Fund Award
Amount £427 (GBP)
Organisation King's College London 
Sector Academic/University
Country United Kingdom
Start 04/2018 
End 04/2019
 
Description Autism Podcast (Title: What it's like to be a Black autism researcher) - Spectrum News) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact I recorded a podcast episode ('What it's like to be a Black autism researcher') with Spectrum News, an international platform for news and expert opinion on autism research. Along with three other PhD students, I shared my experiences as a Black autism researcher. We discussed the emotional and cognitive toll of police brutality and the resurgence of the Black Lives Matter movement, in the height of racial injustice during the pandemic in 2020. This led to much engagement on social media and people (other academics, students, general public etc.) reported they had not realised the extent of the burden that racism adds to the personal and professional life of Black women. Some Black autistic people and parents of autistic children reached out to say they were glad to see people who looked like them discussing relevant issues.
Year(s) Of Engagement Activity 2020
URL https://www.spectrumnews.org/features/multimedia/podcasts/what-its-like-to-be-a-black-autism-researc...
 
Description Autism Podcast (Why Aren't You a Doctor Yet?) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Recorded a podcast episode (Episode 45 - Autism) for 'Why Aren't You a Doctor Yet?', a science-based podcast which intersects with tech journalism and pop culture. I spoke about my doctoral research on autism and ADHD, scientific advancements in diagnosis techniques and discussed the role of culture and language in how we perceive autism, particularly when it comes to Black women and girls. The episode also features a Black autistic woman. This led to many discussions within my research team, on social media and with the general public on how being Black can delay the journey to diagnosis for many people. People reported learning a lot about what autism is, and a renewed perspective for the necessary role of an intersectional lens in clinical contexts.
Year(s) Of Engagement Activity 2020
URL https://play.acast.com/s/whyarentyouadoctoryet/episode45-autism
 
Description BASIS Parent Expo 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Discussed and demonstrated aspects of our study to parents of our participants (who are volunteers). Some participants from previous phases and their older siblings were also present. It was an interactive day including live demonstrations, and opportunities for attendees to share thoughts and experiences through different media. This resulted in discussions regarding the unique understanding that parents gain from each other by taking part in our study. Some expressed that it was supportive to have a non-judgemental space to share their experiences of having autistic children. The children who attended (previous participants) expressed that they were happy to be able to contribute to research from which findings may go on to help autistic people (including their siblings) and their families. Generally, families expressed that they would be keen to continue their involvement in our research, should the funding be available.
Year(s) Of Engagement Activity 2019
 
Description Linear Mixed Models Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Created and co-delivered a practical statistical methods workshop on Linear Mixed Models (LMMs), to teach attendees (PhD students and post-doctoral researchers) seeking to use this method. It included theory, running and interpreting LMMs, and plotting results. This led to discussion about benefits and pitfalls of complex statistical analysis. Researchers who attended gave positive feedback - they found it helpful and reported that the materials have since helped them with their analyses. There were requests for us to deliver similar statistical workshops in future.
Year(s) Of Engagement Activity 2020
URL https://www.eventbrite.com/e/a-workshop-on-mixed-models-tickets-121369765235
 
Description Panel Member - Windrush Legacy: The Power of Education 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Undergraduate students
Results and Impact Panel member among other Undergraduate, Postgraduate and Senior Black academics, discussing the legacy of the Windrush generation, and inspiring the next generation of Black researchers through sharing our journey and some advice. People reached out to say how inspired they were and how useful the advice we shared was for their next steps.
Year(s) Of Engagement Activity 2020
 
Description Pint of Science 2020 Live Show - Title: 'Skin, Society, Science' 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact I was a panellist on Live Show 11 ('Skin, Society, Science') of Pint of Science 2020, a global science communication platform. On the show, we gave an insight into our lives as Black scientists based in the UK and the USA. I shared about my work, achievements, the importance of community (e.g. Black in Neuro, the West African Research Collective (of which I am co-founder) and the African-Caribbean Research Collective) and particularly how being a Black PhD student influences the perceptions of the wider society. There was a live Q&A where we engaged with the general public's questions about the various topics covered. Further, this led to much discussion and social media buzz, particularly from undergraduate and post-graduate researchers who felt inspired by the panel discussions.
Year(s) Of Engagement Activity 2020
URL https://pintofscience.co.uk/event/skin-society-science
 
Description Presentation - Oxford Autism Group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact I delivered a presentation on my preliminary PhD research findings to the Oxford Autism Group. The audience was mainly post-doctoral researchers and senior academics in the field of autism and experimental psychology; though it was made available to the cohort of Psychology Master's students thereafter. My presentation generated discussion about longitudinal research with infant siblings at elevated likelihood for autism and ADHD, and provided an opportunity to network with other academics.
Year(s) Of Engagement Activity 2020
 
Description STEM Ambassadors: Black History Month - 'You Can't Be What You Can't See' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Panel member on Black History Month event with STEM Learning, a national platform for STEM education. Shared my experience as a STEM ambassador, my journey to PhD study, and some advice for school-age students. This generated questions as part of the live Q&A, and parents/teachers fed back that they found the event incredibly useful.
Year(s) Of Engagement Activity 2020
URL https://www.stem.org.uk/
 
Description West London Schools - Key Stage 3 Memory Project 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Designing, demonstrating and facilitating an extra-curricular small group project for 15-20 students aged 12-13 based on Psychology. I am a Postgraduate student partner with Ealing Fields High School. Along with their teacher, I help the students learn all about Memory and work towards designing research posters which they will present in Spring/Summer 2021. The students were intrigued to know about my research, what it's like doing a PhD, and had many questions about the role of memory in day-to-day life.
Year(s) Of Engagement Activity 2020
URL https://ealingfields.org.uk/