Tony Charman

Institute of Psychiatry, Psychology & Neuroscience, King's College London · Department of Psychology

Background Very large sample sizes are often needed to capture heterogeneity in autism, necessitating data sharing across multiple studies with diverse assessment instruments. In these cases, data harmonization can be a critical tool for deriving a single dataset for analysis. This can be done through computational approaches that enable the conver...

The COVID-19 pandemic presented a great challenge for individuals around the globe, and particularly for vulnerable populations such as autistic children. This qualitative study explored the experience of autistic children (both verbal and minimally verbal) and their families during the pandemic in August-October 2020 through the lens of 18 parents...

Introduction Advancing research and support for neurologically diverse populations requires novel data harmonisation methods that are capable of aligning with contemporary approaches to understanding health and disability. Objectives We present the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework t...

Background Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization’s Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and ada...

Executive Functions (EFs) enable us to control attention and behaviour in pursuit of a goal. In this longitudinal study, 107 children with a family history of autism and/or ADHD (FH-autism/ADHD), and 24 children with no FH-autism/ADHD completed a battery of EF tasks (5 tasks at age 2 years, 7 tasks at age 3 years). Parents reported on their child’s...

Atypical functional connectivity (FC) in autism is a common finding, but the results of individual studies are often inconsistent and sometimes contradictory. Classical reliance on case-control comparisons of group means that ignore the inter-individual heterogeneity autism may be a key drive of this inconsistency. Here, we used normative modelling...

Importance In the neurotypical brain, regions develop in coordinated patterns, providing a fundamental scaffold for brain function and behavior. Whether altered patterns contribute to clinical profiles in neurodevelopmental conditions, including autism, remains unclear. Objectives To examine if, in autism, brain regions develop differently in rela...

Background: Children with Neurofibromatosis 1 (NF1) show cognitive, behavioural and social differences compared to their peers. However, the age and sequence at which these differences begin to emerge is not fully understood. This prospective cohort study examines the cognitive, behavioural, ADHD trait and autism symptom development in infant and...

This study examined the recurrence rate of autism in siblings at elevated likelihood (EL) and the predictive validity of the Q-CHAT and ADOS-2 at 14 and 24 months (m) for a clinical best estimate (CBE) autism diagnosis at 3 years. 331 EL-siblings (47.9% girls) from the prospective longitudinal EuroSibs study underwent ADOS-2 assessments and caregiv...

Qualitative EEG abnormalities are common in Autism Spectrum Disorder (ASD) and hypothesized to reflect disrupted excitation/inhibition balance. To test this, we recently introduced a functional measure of network-level E/I ratio (fE/I). Here, we applied fE/I and other quantitative EEG measures to alpha oscillations from source-reconstructed data in...

Longitudinal research can assess how diverging development of multiple cognitive skills during infancy, as well as familial background, are related to the emergence of neurodevelopmental conditions. Sensorimotor and effortful control difficulties are seen in infants later diagnosed with autism; this study explored the relationships between these sk...

Cognitive markers may in theory be more sensitive to the effects of intervention than overt behavioral measures. The current study tests the impact of the Intervention with the British Autism Study of Infant Siblings—Video Interaction for Promoting Positive Parenting (iBASIS‐VIPP) on an eye‐tracking measure of social attention: dwell time to the re...

OBJECTIVES Autism spectrum disorder (ASD) is estimated to be ∼10 times higher in children with versus without an autistic sibling in population-based studies. Prospective studies of infant siblings have revealed even higher familial recurrence rates. In the current prospective longitudinal study, we provide updated estimates of familial ASD recurre...

Autism sibling recurrence in prospective infant family history studies is ~20% at 3 years but systematic follow‐up to mid‐childhood is rare. In population and clinical cohorts autism is not recognized in some children until school‐age or later. One hundred and fifty‐nine infants with an older sibling with autism underwent research diagnostic assess...

Developmental antecedents of autism may affect parent–infant interactions (PII), altering the context in which core social skills develop. While studies have identified differences in PII between infants with and without elevated likelihood (EL) for autism, samples have been small. Here, we examined whether previously reported differences are repli...

Background The neurobiology of autism remains poorly understood. Brain sulcation is a promising proxy to assess the cortical developmental trajectory in autism spectrum disorders. We aimed to explore this neurodevelopmental marker in children with autism and its association with symptoms in a large multicentric dataset. Methods 841 children with a...

Face-processing timing differences may underlie visual social attention differences between autistic and non-autistic people, and males and females. This study investigates the timing of the effects of neurotype and sex on face-processing, and their dependence on age. We analysed EEG data during upright and inverted photographs of faces from 492 pa...

Background Neurodevelopmental conditions frequently co‐occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred t...

Introduction Autism is a common neurodevelopmental condition with a complex genetic aetiology that includes contributions from monogenic and polygenic factors. Many autistic people have unmet healthcare needs that could be served by genomics-informed research and clinical trials. The primary aim of the European Autism GEnomics Registry (EAGER) is t...

This study reports feasibility, fidelity and acceptability of a pilot of START; a 12‐week parent‐toddler, group‐based, neurodiversity‐affirming programme aiming to support executive function development in toddlers at elevated likelihood of autism or ADHD. After 4 days' training, community early years practitioner pairs delivered START to 13 UK fam...

We investigated autistic children’s generalisation of social communication over time across three settings during a play-based assessment with different adults and explore the potential moderating effects on generalisation of age, nonverbal IQ and level of restricted and repetitive behaviours. The social communication abilities of 248 autistic chil...

Identifying factors linked to autism traits in the general population may improve our understanding of the mechanisms underlying divergent neurodevelopment. In this study we assess whether factors increasing the likelihood of childhood autism are related to early autistic trait emergence, or if other exposures are more important. We used data from...

Purpose: Infants later diagnosed with autism typically have smaller vocabularies than their peers. The MacArthur-Bates Communicative Developmental Inventory (CDI) and the Mullen Scales of Early Learning (MSEL) are key tools for assessing infants' language abilities, but it remains unclear what the association is between these measures in infancy, a...

Background Attention-Deficit/Hyperactivity Disorder (ADHD) is linked to strengths in creative problem-solving amongst school-aged children and adults. In contrast, autism (which frequently co-occurs with ADHD) is associated with lower generativity, and perseverative responses during problem-solving. Little is known about how ADHD and autism traits...

Social camouflaging in autism involves hiding social differences and autistic traits to fit in with neurotypical settings and is associated with poorer mental health in both autistic adolescents and adults. This study explored the association between self-reported social camouflaging behaviours and adolescents’ self-report of generalised anxiety di...

Differences in face processing are commonly reported in case/control studies of autism. Their neural correlates have been explored extensively across single neuroimaging modalities within key regions of the face processing network, such as the fusiform gyrus (FFG). Nonetheless, it is poorly understood how different variation(s) in brain anatomy and...

Autism and ADHD are characterised by atypical sensory responsivity, and this may be driven by alterations in the balance of cortical excitation to inhibition (E/I). Studies in early development are required to establish the primary of effects. We utilised data from a prospective longitudinal cohort of infants with and without a family history (FH)...

Background Differences in face processing are commonly reported in case/control studies of autism. Their neural correlates have been explored extensively across single neuroimaging modalities within key regions of the face processing network, such as the fusiform gyrus (FFG). Nonetheless, it is poorly understood how different variation(s) in brain...

Background Existing evidence indicates that atypical sensory reactivity is a core characteristic of autism, and has been linked to both anxiety (and its putative infant precursor of fearfulness) and repetitive behaviours. However, most work has used cross‐sectional designs and not considered the differential roles of hyperreactivity and hyporeactiv...

Objective: This prospective cohort study examines the cognitive, behavioural, ADHD trait and autism symptom development in infant and pre-school children with Neurofibromatosis 1 (NF1) compared with typically developing (TD) children without a family history of neurodevelopmental conditions. Methods: Data from standardised tests was gathered at 5,...

Big data approaches in mental health research hold great promise to advance research and support for neurologically diverse populations. The Risk, Resilience and Developmental Diversity in Mental Health (R2D2-MH) project moves from risk-focused studies toward understanding and promoting resilience, and from a diagnosis-based approach to a developme...

Objective Attention Deficit Hyperactivity Disorder (ADHD) is a common co-occurring condition in autistic individuals. ADHD is sometimes first recognised in young adulthood because ADHD symptoms may be misattributed to autism due to superficial overlap in presentation and diagnostic overshadowing. It should be investigated whether ADHD questionnaire...

Aim To characterize early changes in developmental ability, language, and adaptive behaviour in infants diagnosed with tuberous sclerosis complex (TSC), and determine whether clinical features of epilepsy influence this pathway. Method Prospective, longitudinal data were collected within the Early Development in Tuberous Sclerosis (EDiTS) Study to...

Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample ( n = 764; 453 aut...

Introduction: Autism is a common neurodevelopmental condition with a complex genetic aetiology that includes contributions from monogenic and polygenic factors. Many autistic people have unmet healthcare needs that could be served by genomics-informed research and clinical trials. The primary aim of the European Autism GEnomics Registry (EAGER) is...

Background: Autism spectrum disorders (ASD) are neurodevelopmental conditions accompanied by differences in brain development. Neuroanatomical differences in autism are variable across individuals and likely underpin distinct clinical phenotypes. To parse heterogeneity, it is essential to establish how the neurobiology of ASD is modulated by diffe...

Slower acquisition of language and motor milestones are common in infants with later autism and studies have indicated that motor skills predict the rate of language development, suggesting these domains of development may be interlinked. However, the inter‐relationships between the two domains over development and emerging autistic traits are not...

Background Neurofibromatosis Type 1 is a genetic condition diagnosed in infancy that substantially increases the likelihood of a child experiencing cognitive and developmental difficulties, including Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). One of the most characteristic cognitive differences observed in c...

Neuroimaging analyses of brain structure and function in autism have typically been conducted in isolation, missing the sensitivity gains of linking data across modalities. Here we focus on the integration of structural and functional organisational properties of brain regions. We aim to identify novel brain-organisation phenotypes of autism. We ut...

Background Social camouflaging (hereafter camouflaging) in autism includes factors such as masking and compensating for one's neurodevelopmental differences, and to assimilate or ‘fit in’ with non‐autistic peers. Efforts to hide one's authentic self and autism traits (masking) resemble impression management (IM) in safety behaviours identified in C...

Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data was taken from two cohorts: a multinational European sample (n= 764; 453 Autist...

Background Most research on early outcomes in infants with a family history (FH) of autism has focussed on categorically defined autism, although some have language and developmental delays. Less is known about outcomes in infants with a FH of attention deficit hyperactivity disorder (ADHD). Methods Infants with and without a FH of autism and/or A...

A paradigm shift in research culture is required to ease perceived tensions between autistic people and the biomedical research community. As a group of autistic and non-autistic scientists and stakeholders, we contend that through participatory research, we can reject a deficit-based conceptualization of autism while building a shared vision for a...

Sensory atypicalities are particularly common in autism spectrum disorders (ASD). Nevertheless, our knowledge about the divergent functioning of the underlying somatosensory region and its association with ASD phenotype features is limited. We applied a data-driven approach to map the fine-grained variations in functional connectivity of the primar...

Background: Autism is a heterogenous neurodevelopmental condition accompanied by differences in brain connectivity. Structural connectivity in autism has mainly been investigated within the white matter. However, many genetic variants associated with autism highlight genes related to synaptogenesis and axonal guidance, thus also implicating differ...

Background: Despite much research on socioeconomic status (SES) from global health perspectives, surprisingly little has focused on autistic individuals. As this gap is integral to address the cognitive and mental health vulnerability of the vast majority of autistic people living in middle-to-low income settings (Lord, Charman, Havdal et al., 2022...

Neuroimaging analyses of brain structure and function in autism have typically been conducted in isolation, missing the sensitivity gains of linking data across modalities. Here we focus on the integration of structural and functional organisational properties of brain regions. We aim to identify novel brain-organisation phenotypes of autism. We ut...

Background There are very few mechanistic studies of the long‐term impact of psychosocial interventions in childhood. The parent‐mediated Paediatric Autism Communication Therapy (PACT) RCT showed sustained effects on autistic child outcomes from pre‐school to mid‐childhood. We investigated the mechanism by which the PACT intervention achieved these...

Individuals with autism spectrum disorder (henceforth referred to as autism) display significant variation in clinical outcome. For instance, across age, some individuals’ adaptive skills naturally improve or remain stable, while others’ decrease. To pave the way for ‘precision-medicine’ approaches, it is crucial to identify the cross-sectional and...

Background Children with neurodevelopmental disorders including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often experience sleep disturbances, but little is known about when these sleep differences emerge and how they relate to later development. Methods We used a prospective longitudinal design in infants...

The current study explored the role of pre-existing and pandemic-time child, family or environmental factors in the presentation of mental health symptoms of autistic youth and their parents during the pandemic. Participants were parents/carers of autistic children (Autism Spectrum Treatment and Resilience Cohort, N = 67, M age = 9 years) and adole...

Background Attention‐deficit/hyperactivity disorder (ADHD) is a prevalent, impairing, and highly heritable condition typically diagnosed in middle childhood. However, it is now recognized that symptoms emerge much earlier in development. Research focused on understanding—using multiple units of analysis—the cascade of early‐life (i.e., prenatal‐inf...

Background Attenuated social attention is a key marker of autism spectrum disorder (ASD). Recent neuroimaging findings also emphasize an altered processing of sensory salience in ASD. The locus coeruleus–norepinephrine system (LC-NE) has been established as a modulator of this sensory salience processing (SSP). We tested the hypothesis that altered...

Background: Reward processing has been proposed to underpin the atypical social feature of autism spectrum disorder (ASD). However, previous neuroimaging studies have yielded inconsistent results regarding the specificity of atypicalities for social reward processing in ASD. Aims: Utilising a large sample, we aimed to assess reward processing in...

The excitatory/inhibitory (E/I) imbalance hypothesis posits that imbalance between excitatory (glutamatergic) and inhibitory (GABAergic) mechanisms underlies the behavioral characteristics of autism. However, how E/I imbalance arises and how it may differ across autism symptomatology and brain regions is not well understood. We used innovative anal...

Objective Most young autistic children display emotional and behavioral problems (EBPs). There is evidence that behavioral parenting interventions (BPIs) reduce these. The COVID-19 pandemic and associated lockdowns can be seen as a natural experiment to test the longer-term effect of BPIs under conditions of increased uncertainty. Method Opportuni...

Background Autism Spectrum Disorder (ASD) and Attention‐Deficit/Hyperactivity Disorder (ADHD) are both associated with differences in Executive Functioning (EF). There is lack of clarity around the specificity or overlap of EF differences in early childhood when both disorders are first emerging. Method This systematic review aims to delineate pre...

Background: Autism spectrum disorder (autism) is a complex neurodevelopmental condition with pronounced behavioral, cognitive, and neural heterogeneities across individuals. Here, our goal was to characterize heterogeneity in autism by identifying patterns of neural diversity as reflected in BOLD fMRI in the way individuals with autism engage with...

This study describes social, mental health, and quality of life outcomes in early adulthood, and examines childhood predictors in the Special Needs and Autism Project (SNAP), a longitudinal population-based cohort. Young autistic adults face variable but often substantial challenges across many areas of life. Prediction of outcomes is important to...

As an integral part of autism spectrum symptoms, sensory processing issues including both hypo and hyper sensory sensitivities. These sensory specificities may result from an excitation/inhibition imbalance with a poorly understood of their level of convergence with genetic alterations in GABA-ergic and glutamatergic pathways. In our study, we aime...

Theta oscillations (spectral power and connectivity) are sensitive to the social content of an experience in typically developing infants, providing a possible marker of early social brain development. Autism is a neurodevelopmental condition affecting early social behaviour, but links to underlying social brain function remain unclear. We explored...

Background: Autism is proposed to be characterised by an atypical balance of cortical excitation and inhibition (E/I). However, most studies have examined E/I alterations in older autistic individuals, meaning that findings could in part reflect homeostatic compensation. To assess the directionality of effects, it is necessary to examine alteratio...

Background Neuroimaging studies on functional connectivity (FC) in autism have been hampered by small sample sizes and inconsistent findings with regard to whether connectivity is increased or decreased in autistic individuals, whether these alterations affect focal systems or reflect a brain-wide pattern, and whether these are age- and/or sex-depe...

Background: Autism is proposed to be characterised by an atypical balance of cortical excitation and inhibition (E/I). However, most studies have examined E/I alterations in older autistic individuals, meaning that findings could in part reflect homeostatic compensation. To assess the directionality of effects, it is necessary to examine alteration...

Background: Existing evidence indicates that atypical sensory processing is a core characteristic of autism, and has been linked to both anxiety and repetitive behaviours. However, most work has used cross-sectional designs and not considered the differential roles of hyper and hyposensitivity to sensory inputs, and is thus limited in specificity....

Objective: The male preponderance in prevalence of autism is among the most pronounced sex ratios across neurodevelopmental conditions. The authors sought to elucidate the relationship between autism and typical sex-differential neuroanatomy, cognition, and related gene expression. Methods: Using a novel deep learning framework trained to predic...

Background Infants of parents with perinatal anxiety are at elevated likelihood of experiencing disruption in the parent‐infant relationship, as well as difficulties with socio‐emotional functioning in later development. Interventions delivered in the perinatal period have the potential to protect the early dyadic relationship and support infants’...

Background Difficulties in social communication are a defining clinical feature of autism. However, the underlying neurobiological heterogeneity has impeded targeted therapies and requires new approaches to identifying clinically relevant bio-behavioural subgroups. In the largest autism cohort to date, we comprehensively examined difficulties in fa...

Lay abstract: Many early autism interventions teach parents therapeutic strategies to help them adjust their communication style with their children. Research has shown that this behaviour change in parents leads to improvements in child communication. It is, therefore, important to learn what factors support or hinder parents in their use of ther...

We studied the feasibility and preliminary efficacy of a brief parent-mediated intervention to improve the orienting towards faces in young autistic children. Twenty (aged 3–6) autistic children were randomly assigned to an intervention or a control group. The intervention group parents were trained to perform three types of practices with their ch...