Correlates of Head Circumference Growth in Infants Later Diagnosed With Autism Spectrum Disorders

ArticleinJournal of Child Neurology 22(6):700-13 · July 2007with13 Reads
DOI: 10.1177/0883073807304005 · Source: PubMed
Previous research has demonstrated that children diagnosed with autism spectrum disorder show an abnormal acceleration of head growth during the first year of life. This study attempts to replicate these findings and to determine whether overgrowth is associated with clinical outcome. Measurements of head circumference, body length, and body weight taken during the first 2 years of life were obtained from a sample of 35 children diagnosed with autism spectrum disorder and compared to both national normative data (Centers for Disease Control and Prevention) and a control group of 37 healthy infants. Results demonstrated that compared to national averages, infants who were later diagnosed with autism spectrum disorder had a significantly smaller head circumference at birth to 2 weeks and a significantly larger head circumference by 10 to 14 months. Children with autism spectrum disorder were also significantly longer and heavier beginning at 1 to 2 months. However, when overall length and weight were controlled, head circumference was not bigger in the autistic spectrum disorder group compared to local controls. Correlations between head circumference and clinical outcome were significant for 5 of the 30 clinical variables that were run, suggesting that there appears to be no simple or straightforward relationship between head circumference and clinical outcome. Smaller head circumference at birth to 2 weeks was associated with a greater number of symptoms related to social impairment and a greater total number of autism spectrum disorder symptoms based on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition criteria. Larger head circumference at 15 to 25 months was also associated with a greater number of symptoms of social impairment. In addition, greater head circumference change during the first 2 years was associated with poorer performance on the visual reception subtest of the Mullen Scales of Early Learning and a smaller number of stereotyped and repetitive behaviors and interests based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. These findings support previous findings of accelerated brain growth during the first year of life in autism spectrum disorder and question whether growth factors might contribute to both accelerated brain growth and overall body growth.
    • "It is hypothesized that in children with ASD, the brain undergoes an abnormal growth trajectory that includes a period of early overgrowth. This theory is supported by neuroimaging and neuropathological findings (Courchesne et al., 2003Courchesne et al., , 2007 Mraz et al., 2007; Webb et al., 2007). Whether macrocephaly is associated with specific clinical presentation in ASD has been inconsistently reported in previous studies. "
    [Show abstract] [Hide abstract] ABSTRACT: Autism spectrum disorder (ASD) is a heterogeneous group of disorders which occurs with numerous medical conditions. In previous research, subtyping in ASD has been based mostly on cognitive ability and ASD symptom severity. The aim of the current study was to investigate whether specific medical conditions in ASD are associated with unique behavioral profiles. The medical conditions included in the study were macrocephaly, microcephaly, developmental regression, food selectivity, and sleep problems. The behavioral profile was composed of cognitive ability, adaptive skills, and autism severity, and was examined in each of the aforementioned medical conditions. The study population included 1224 participants, 1043 males and 181 females (M:F ratio = 5.8:1) with a mean age of 49.9 m (SD = 29.4) diagnosed with ASD using standardized tests. Groups with and without the specific medical conditions were compared on the behavioral measures. Developmental regression was present in 19% of the population and showed a more severe clinical presentation, with lower cognitive abilities, more severe ASD symptoms, and more impaired adaptive functioning. Microcephaly was observed in 6.3% of the population and was characterized by a lower cognitive ability and more impaired adaptive functioning in comparison to the normative head circumference (HC) group. Severe food selectivity was found in 9.8% and severe sleep problems in 5.1% of the ASD population. The food selectivity and sleep problem subgroups, both showed more severe autism symptoms only as described by the parents, but not per the professional assessment, and more impaired adaptive skills. Macrocephaly was observed in 7.9% of the ASD population and did not differ from the normative HC group in any of the examined behavioral measures. Based on these findings, two unique medical-behavioral subtypes in ASD that affect inherited traits of cognition and/or autism severity were suggested. The microcephaly phenotype occurred with more impaired cognition and the developmental regression phenotype with widespread, more severe impairments in cognition and autism severity. In contrast, severe food selectivity and sleep problems represent only comorbidities to ASD that affect functioning. Defining specific subgroups in ASD with a unique biological signature and specific behavioral phenotypes may help future genetic and neuroscience research.
    Full-text · Article · Sep 2016
    • "Along with increased stature reported in many studies, children with an ASD also displayed increased weight and body mass index (BMI), which correlates with other increased physical growth measurements (Chawarska et al., 2011; Dissanayake et al., 2006; Fukumoto et al., 2008; Gillberg, 2002; Mills et al., 2007; Mraz et al., 2007; van Daalen et al., 2007; Xiong et al., 2009 ). Mraz et al. found increased weight at only 1–2 months of age in children with ASD, while Fukumoto et al. reported increased weight at 3, 6, and 12 months in children with HFA, and at 3 and 12 months in children with lowfunctioning autism (IQ < 70) compared with TD children. "
    [Show abstract] [Hide abstract] ABSTRACT: Head circumference growth in individuals with an Autism Spectrum Disorder (ASD) has been well characterized in the first two to three years of life and reflects a period of acceleration followed by a period of deceleration when compared with their typically developing (TD) peers. While this altered growth trajectory has been consistently found for head circumference, it is less clear if an abnormal growth trajectory also exists across measures of height and weight. Moreover, most studies have focused on infancy and early childhood, and no longitudinal data have been collected in older children with ASD. This review focuses on the physical growth trajectory of individuals with ASD, and proposes that a general growth dysregulation is present in ASD, and that an endophenotype within ASD may exist that is characteristic of extreme overgrowth. Two possible explanations for a general growth dysregulation are suggested: (1) a connective tissue disorder, which is frequently associated with increased height and disproportionate body ratios; and (2) a dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, which regulates growth hormones. The existence of a general growth dysregulation, and possible endophenotype, may serve as a potential biological marker in ASD.
    Full-text · Article · Feb 2015
    • "It is hypothesized that the brain in children with autism undergoes an abnormal growth trajectory that includes a period of early overgrowth . This theory is supported by neuroimaging and neuropathological findings [Courchesne, Carper, & Akshoomoff, 2003; Courchesne et al., 2007; Mraz, Green, Dumont-Mathieu, Makin, & Fein, 2007; Webb et al., 2007]. In general, our study found that the representation of both sexes in the macro-and microcephalic groups was higher than the 3% expected in the general population (18.1% and 5.9% respectively). "
    [Show abstract] [Hide abstract] ABSTRACT: Autism spectrum disorder (ASD) is a heritable disorder occurring predominantly in males. The aim of this study was to compare sex differences in the prevalence of specific neurological phenotypes commonly described in ASD. The study included 663 participants, aged 18 months to 15 years, diagnosed with ASD. Neurological and behavioral assessments were performed using standardized tests, and obtaining medical, developmental, and familial histories from the parents. Phenotypes under investigation were macro- and microcephaly, developmental regression, minor neurological and musculoskeletal deficits (MNMD), and seizures. Male : female ratio in the ASD group was 6.7:1. No sex differences in autism severity, cognitive ability, and adaptive functioning were noted. Mean head circumference percentile for males (50.1 ± 25.6) was significantly larger than females (43.4 ± 30.2). Micro- and macrocephaly were more frequent in ASD than expected (5.9%; 18.1%, respectively). Microcephaly in females (15.1%) was significantly more prevalent than in males (4.5%). The prevalence of macrocephaly in both sexes did not differ significantly. Regression was noted in 30.2% of the females with ASD, significantly higher than in males (18.9%). MNMD was documented in 73.8% of the females, significantly higher than in males (57.1%). M:F ratio decreased in a group with two or more phenotypes (3.6:1), while male predominance was more significant in the group without phenotypes (13.6:1). Neurological phenotypes associated with ASD are more prevalent in females than in males, resulting in more complex clinical and neurological manifestations in females. Therefore, involvement of different etiologies is suggested in ASD in females. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
    Article · Dec 2013
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