Geraldine Dawson

Geraldine Dawson
University of North Carolina at Chapel Hill | UNC · Department of Psychiatry

About

252
Publications
99,551
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40,247
Citations
Citations since 2016
64 Research Items
18970 Citations
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201620172018201920202021202205001,0001,5002,0002,500

Publications

Publications (252)
Article
Full-text available
Diffusion tensor imaging (DTI) has been used as an outcome measure in clinical trials for several psychiatric disorders but has rarely been explored in autism clinical trials. This is despite a large body of research suggesting altered white matter structure in autistic individuals. The current study is a secondary analysis of changes in white matt...
Article
Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. T...
Preprint
Background: Autism spectrum disorder (ASD) is defined behaviorally, but measures that probe underlying neural mechanisms may provide clues to biomarker discovery and brain-based patient stratification with clinical utility. Phase-amplitude coupling (PAC) has been posited as a measure of the balance between top-down and bottom-up processing in corte...
Article
Lay abstract: Children with autism spectrum disorder are prescribed a variety of medications that affect the central nervous system (psychotropic medications) to address behavior and mood. In clinical trials, individuals taking concomitant psychotropic medications often are excluded to maintain homogeneity of the sample and prevent contamination o...
Article
Full-text available
Eye tracking (ET) experiments commonly record the continuous trajectory of a subject’s gaze on a two-dimensional screen throughout repeated presentations of stimuli (referred to as trials). Even though the continuous path of gaze is recorded during each trial, commonly derived outcomes for analysis collapse the data into simple summaries, such as l...
Article
Objective: Numerous candidate EEG biomarkers have been put forward for use in clinical research on autism spectrum disorder (ASD), but biomarker development has been hindered by limited attention to the psychometric properties of derived variables, inconsistent results across small studies, and variable methodology. The authors evaluated the basic...
Chapter
Differential Diagnosis of Autism Spectrum Disorder describes clinical considerations and best practices related to diagnosing children with autism spectrum disorder (ASD) versus commonly co-occurring conditions. Each chapter focuses on the similarities and differences between ASD and a second diagnosis. For example, one chapter outlines clinical co...
Article
Full-text available
Visual exploration paradigms involving object arrays have been used to examine salience of social stimuli such as faces in ASD. Recent work suggests performance on these paradigms may associate with clinical features of ASD. We evaluate metrics from a visual exploration paradigm in 4-to-11-year-old children with ASD (n = 23; 18 males) and typical d...
Article
When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care,...
Article
Electroencephalography experiments produce region‐referenced functional data representing brain signals in the time or the frequency domain collected across the scalp. The data typically also have a multilevel structure with high‐dimensional observations collected across multiple experimental conditions or visits. Common analysis approaches reduce...
Article
Introduction Sleep problems are common, impairing correlates of ADHD. These associations may emerge as early as toddlerhood, suggesting sleep-focused interventions in early development may improve ADHD-related outcomes. However, previous research has been limited by cross-sectional methodology and small, clinically-referred samples. Thus, relations...
Article
Full-text available
Recent proposals have suggested the potential for neural biomarkers to improve clinical trial processes in neurodevelopmental conditions; however, few efforts have identified whether chronological age-based adjustments will be necessary (as used in standardized behavioral assessments). Event-related potentials (ERPs) demonstrate early differences i...
Article
Full-text available
Background Eye tracking (ET) is a powerful methodology for studying attentional processes through quantification of eye movements. The precision, usability, and cost-effectiveness of ET render it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder (ASD). Methods The autism biomarkers consortium fo...
Article
Full-text available
Eye-tracking is often used to study attention in children with autism spectrum disorder (ASD). Previous research has identified multiple atypical patterns of attention in children with ASD based on areas-of-interest analysis. Fewer studies have investigated gaze path, a measure which is dependent on the dynamic content of the stimulus presented. He...
Article
Atypical facial expression is one of the early symptoms of autism spectrum disorder (ASD) characterized by reduced regularity and lack of coordination of facial movements. Automatic quantification of these behaviors can offer novel biomarkers for screening, diagnosis, and treatment monitoring of ASD. In this work, 40 toddlers with ASD and 396 typic...
Article
We examined the relationship between the Early start Denver model (ESDM) intervention and mu rhythm attenuation, an EEG paradigm reflecting neural processes associated with action perception and social information processing. Children were assigned to either receive comprehensive ESDM intervention for two years, or were encouraged to pursue resourc...
Article
Full-text available
Participants with autism spectrum disorder (ASD) (n = 121, mean [SD] age: 14.6 [8.0] years) and typically developing (TD) controls (n = 40, 16.4 [13.3] years) were presented with a series of videos representing biological motion on one side of a computer monitor screen and non-biological motion on the other, while their eye movements were recorded....
Article
Lay abstract: COVID-19 caused many autism spectrum disorder caregiver-coaching studies to move to telehealth. Telehealth can increase the diversity of people who take part in research. This matters because most autism spectrum disorder studies have included people who have resources, are White, and live in North America and Europe. When study part...
Article
In 2017, facing lack of progress and failures encountered in targeted drug development for Autism Spectrum Disorder (ASD) and related neurodevelopmental disorders, the ISCTM with the ECNP created the ASD Working Group charged to identify barriers to progress and recommending research strategies for the field to gain traction. Working Group internat...
Poster
Full-text available
BACKGROUND: Observational behavior analysis of children, which is critical for the evaluation, monitoring, and discovery of biomarkers related to Autism Spectrum Disorder (ASD), is performed in-person by trained clinicians. With the rapid development of computer vision and machine learning technology, scalable and objective methods make automatic a...
Article
Importance: Atypical eye gaze is an early-emerging symptom of autism spectrum disorder (ASD) and holds promise for autism screening. Current eye-tracking methods are expensive and require special equipment and calibration. There is a need for scalable, feasible methods for measuring eye gaze. Objective: Using computational methods based on compu...
Article
Background: This study is part of a larger research program focused on developing objective, scalable tools for digital behavioral phenotyping. We evaluated whether a digital app delivered on a smartphone or tablet using computer vision analysis (CVA) can elicit and accurately measure one of the most common early autism symptoms, namely failure to...
Article
Full-text available
Sleep problems are prevalent in children with neurodevelopmental disabilities and are associated with the expression of restricted and repetitive behaviors (RRBs). Children (n = 57) with autism spectrum disorder (ASD, n = 38) or developmental delay (DD, n = 19) participated in multiple assessments of intellectual ability, ASD symptoms, and RRBs (3...
Article
Full-text available
Background Diminished visual monitoring of faces and activities of others is an early feature of autism spectrum disorder (ASD). It is uncertain whether deficits in activity monitoring, identified using a homogeneous set of stimuli, persist throughout the lifespan in ASD, and thus, whether they could serve as a biological indicator (“biomarker”) of...
Article
Individuals with autism spectrum disorder are more likely than typically developing individuals to experience a range of gastrointestinal abnormalities, including chronic diarrhea, constipation, food sensitivities, and abdominal pain. These gastrointestinal symptoms have been associated with higher levels of irritability and aggressive behavior, bu...
Article
Commonly used screening tools for autism spectrum disorder (ASD) generally rely on subjective caregiver questionnaires. While behavioral observation is more objective, it is also expensive, time‐consuming, and requires significant expertise to perform. As such, there remains a critical need to develop feasible, scalable, and reliable tools that can...
Article
Full-text available
Objective This randomized, multisite, intent-to-treat study tested the effects of two levels of treatment intensity (number of hours) and two treatment styles on progress of young children with autism spectrum disorder (ASD). We predicted that initial severity of developmental delay or autism symptoms would moderate the effects of intensity and sty...
Article
Full-text available
Ollivier–Ricci curvature is a method for measuring the robustness of connections in a network. In this work, we use curvature to measure changes in robustness of brain networks in children with autism spectrum disorder (ASD). In an open label clinical trials, participants with ASD were administered a single infusion of autologous umbilical cord blo...
Chapter
The Early Start Denver Model (ESDM; Rogers and Dawson in The Early Start Denver Model for Young Children with Autism: Promoting Language, Learning, and Engagement. Guilford Press, New York, 2010) is an evidence-based early intervention designed to promote developmental and social communication skills in young children with autism spectrum disorder...
Article
Full-text available
There is a need for measures to track symptom change in autism spectrum disorder (ASD). We conducted a validation study on a revised version of the Autism Behavior Inventory (ABI), and a short form (ABI-S). Caregivers of individuals (6–54 years) with confirmed diagnoses of ASD (N = 144) completed the ABI and other rating scales at 4 time points. Sc...
Article
Full-text available
Ongoing neuroinflammation may contribute to symptoms of autism spectrum disorder (ASD) in at least a portion of affected individuals. Mesenchymal stromal cells (MSCs) have demonstrated the capacity to modulate neuroinflammation, but safety and feasibility of MSC administration in children with ASD have not been well established. In this open‐label,...
Article
Lay abstract: This was a project in primary care for young children (1-2 years old). We tested a parent questionnaire on a tablet. This tablet questionnaire asked questions to see whether the child may have autism. We compared the paper and pencil version of the questionnaire to the tablet questionnaire. We read the medical charts for the children...
Article
Full-text available
Background: Reduction or differences in facial expression are a core diagnostic feature of autism spectrum disorder (ASD), yet evidence regarding the extent of this discrepancy is limited and inconsistent. Use of automated facial expression detection technology enables accurate and efficient tracking of facial expressions that has potential to ide...
Article
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Article
Objective To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD). Study design This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous...
Article
Full-text available
Clinical research in neurodevelopmental disorders remains reliant upon clinician and caregiver measures. Limitations of these approaches indicate a need for objective, quantitative, and reliable biomarkers to advance clinical research. Extant research suggests the potential utility of multiple candidate biomarkers; however, effective application of...
Article
Full-text available
Biomarker development is currently a high priority in neurodevelopmental disorder research. For many types of biomarkers (particularly biomarkers of diagnosis), reliability over short periods is critically important. In the field of autism spectrum disorder (ASD), resting electroencephalography (EEG) power spectral densities (PSD) are well-studied...
Article
Full-text available
Objective The relationship between sleep (caregiver-reported and actigraphy-measured) and other caregiver-reported behaviors in children and adults with autism spectrum disorder (ASD) was examined, including the use of machine learning to identify sleep variables important in predicting anxiety in ASD.Methods Caregivers of ASD (n = 144) and typical...
Article
Full-text available
The objective of the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is to evaluate a set of lab-based behavioral video tracking (VT), electroencephalography (EEG), and eye tracking (ET) measures for use in clinical trials with children with autism spectrum disorder (ASD). Within the larger organizational structure of the ABC-CT, the Data...
Article
Numerous potential therapeutic targets are being investigated in autism spectrum disorder (ASD). Here, we discuss a platform trial approach for designing proof-of-concept (POC) clinical studies of ASD — via the Autism Spectrum POC Initiative (ASPI) — that can be conducted through a public–private partnership with the aim of finding effective treatm...
Preprint
Clinical research in neurodevelopmental disorders remains reliant upon clinician and caregiver measures. Limitations of these approaches indicate a need for objective, quantitative, and reliable biomarkers to advance clinical research. Extant research suggests the potential utility of multiple candidate biomarkers; however, effective application of...
Preprint
Full-text available
Biomarker development is currently a high priority in neurodevelopmental disorder research. For many types of biomarkers (particularly biomarkers of diagnosis), reliability over short time periods is critically important. In the field of autism spectrum disorder (ASD), resting electroencephalography (EEG) power spectral densities (PSD) are well-stu...
Article
Objective: This single-blind, randomized, multisite, intent-to-treat study was designed to replicate and extend Dawson et al.'s (Pediatrics. 2010;125: e17-e23) randomized controlled trial testing the effects of the Early Start Denver Model (ESDM), an intensive play- and routines-based intervention delivered in natural settings. Method: A randomi...
Article
Full-text available
Background Currently, no medications are approved to treat core symptoms of autism spectrum disorder (ASD). One barrier to ASD medication development is the lack of validated outcome measures able to detect symptom change. Current ASD interventions are often evaluated using retrospective caregiver reports that describe general clinical presentation...
Article
The aim of this study was to develop a measurement approach to assess the learning opportunities provided by parents to their young children with autism spectrum disorder during a free play task and to examine the relationship between learning opportunities and child performance on measures of cognition, autism spectrum disorder symptoms, and langu...
Conference Paper
Full-text available
Background: Attentional flexibility has been shown to differentiate infants at high risk for autism spectrum disorder (ASD) from infants at low risk for ASD (Elsabbagh et al., 2009). Similarly, children with anxiety have deficits in attentional flexibility, including difficulty disengaging attention between tasks (Eysenck & Calvo, 1992). Approximat...
Chapter
The Early Start Denver Model (ESDM) is an evidence-based intervention approach that incorporates knowledge from developmental science, behavior analysis, and social-affective neuroscience to support learning and development in young children with autism. This chapter describes an approach for delivering ESDM in a group day care setting—the Group-ba...
Chapter
In this chapter we examine the treatment strategies used in the G-ESDM to facilitate learning. These encompass evidence-based techniques based on applied behavioral analysis and developmentally-based strategies to support the child’s ability and motivation to learn during group routines and play activities. The G-ESDM fidelity tool can be used to f...
Chapter
Typically developing children are well equipped to learn from their social environment from infancy. Early learning is supported by attentional preferences for novel events, others’ goal directed actions and communication cues, as well as early maturing abilities to share attention with their social partners, imitating them, understanding their act...
Article
The contributions of Executive Function (EF) to academic achievement in children with Autism Spectrum Disorder (ASD) are not well understood. Academic achievement and its association with EF is described in 32, 9-year-old children with ASD. EF at age 6 and 9, and academic achievement at age 9 were assessed as part of a larger longitudinal study. Be...
Article
Objective To determine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on healthcare service use and costs. Method We use data from a randomized trial that tested the efficacy of the ESDM, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and...
Article
This book examines a group-based adaptation of the Early Start Denver Model (ESDM) designed for use with preschoolers with autism spectrum disorder (ASD). It describes the principles and procedures of the Group-Based Early Start Denver Model (G-ESDM) and provides practical and empirical guidelines for implementing effective, affordable programs acr...
Article
Full-text available
Both autism spectrum (ASD) and anxiety disorders are associated with atypical neural and attentional responses to emotional faces, differing in affective face processing from typically developing peers. Within a longitudinal study of children with ASD (23 male, 3 female), we hypothesized that early ERPs to emotional faces would predict concurrent a...
Article
Objective: To test differences in neural sensitivity to facial expressions, including expressions with open versus closed mouths, exhibited by (1) adults with autism spectrum disorder (ASD) compared to neurotypical adults, and by (2) short versus long serotonin transporter allele (SLC6A4) carriers. Methods: Event related potentials (ERPs) to hap...
Article
Executive function and play skills develop in early childhood and are linked to cognitive and language ability. The present study examined these abilities longitudinally in two groups with autism spectrum disorder—a group with higher initial language (n 5 30) and a group with lower initial language ability (n 5 36). Among the lower language group,...
Article
Autism Spectrum Disorder is the term that is currently used to describe the broad range of pervasive developmental disorders. These disorders include Autistic Disorder, Asperger's Disorder, Rett's Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The Autism spectrum disorders involv...
Article
Abnormal fMRI habituation in autism spectrum disorders (ASDs) has been proposed as a critical component in social impairment. This study investigated habituation to fearful faces and houses in ASD and whether fMRI measures of brain activity discriminate between ASD and typically developing (TD) controls. Two identical fMRI runs presenting masked fe...
Article
Full-text available
To delineate the early progression of autism spectrum disorder (ASD) symptoms, this study investigated developmental characteristics of infants at high familial risk for ASD (HR), and infants at low risk (LR). Participants included 210 HR and 98 LR infants across 4 sites with comparable behavioral data at age 6, 12, and 24 months assessed in the do...
Research
Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (April 01, 2015). Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 1.) We prospectively examine evidence for the sustained effects of early intervention based...
Article
We prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 y...
Chapter
The Early Start Denver Model (ESDM) is a comprehensive, developmental, relationship-based behavioral treatment for toddlers with ASD. It is both manualized and empirically-validated. The ESDM fuses developmental principles with empirically based teaching strategies from applied behavior analysis incorporated throughout the routines that fill childr...
Article
Full-text available
It has been previously reported that structural and functional brain connectivity in individuals with autism spectrum disorders (ASD) is atypical and may vary with age. However, to date, no measures of functional connectivity measured within the first 2 years have specifically associated with a later ASD diagnosis. In the present study, we analyzed...