Early motor signature in autism spectrum disorder

Several evidences showed atypical gross and fine motor functions in infants and children with Autism Spectrum Disorder (ASD). For this reason, motor impairments or abnormalities should be investigated as potential early signs of the disorder and correlated to the severity of its core symptoms. Thus, the early detection of motor abnormalities may be potentially useful to diagnose later social impairments.  Main aim of the present PhD project is to identify early predictors of ASD through the investigation of antenatal and postnatal motor development in fetuses and infants at low- and high-risk for ASD. The underlying hypothesis is that assessment of motor performances may be effective in predicting abnormal outcomes in infants at risk for neurological development. To this aim, two specific experiments have been performed: Experiment 1. Analysis of early motor repertoire in infants at low and high risk for ASD. Experiment 2. Analysis of fetal movements in pregnancies at low and high risk for ASD through ultrasound (US) techniques. All the experimental activities have been performed at the Istituto Superiore di Sanità (ISS) within the Network for early detection of autism spectrum disorders (NIDA) and the European project “Brainview – fetal ultrasound screening for neurodevelopmental disorders in normal and high-risk pregnancies” Marie Sklodowska – Curie actions, Innovative Training Networks (ETN), H2020 –MSCA- ETN-2014. During the Ph.D., I collaborated with Prof. Andrea Guzzetta and his staff at the Stella Maris Foundation on the analysis of infant’s spontaneous movements and with Dr. Maria Bulgheroni (Ab. Acus company) and her staff of bio-engineers on the development and implementation of a software for the kinematic analysis of infant’s movements. To investigate antenatal neurobehaviours of fetuses at risk for ASD, I have collaborated with Dr. Laura Iaconianni, head gynecologist of the “Ultrasound Diagnostic Centre Eco.B.I.” in Rome. Given the importance of further exploring the early motor trajectories in infants with ASD, this study had the overall purpose to collect longitudinal data on motor development of infants at high risk for ASD. The present work has several strengths and gave light to novel findings. First, data from the first experimental study supported the importance of carefully exploring the developmental trajectories of the spontaneous movements in the first 5-6 months of life of infants at high-risk for ASD since potentially predictive of later social impairments. Second, the development of the MOVIDEA software provided the possibility of detecting spontaneous movements for future application in clinical settings. Finally, the standard operative procedures developed to collect and analyze fetal movements and basal biometrical data during 2D and 4D ultrasound recording allow to evaluate possible indicators of an adequate fetal health during the gynecological examination of pregnant women during the first and second trimester.  In conclusion, the present work defined motor prenatal and postnatal trajectories to detect early signs of ASD in at-risk populations. In fact, given the well-established link between motor development and social competencies, it is possible to use this protocol as screenings in clinical settings to identify children at risk for neurodevelopmental disorders early in life and provide them and their families adequate care, services and interventions. Even if the low number of high risk with ASD prevents us from any consideration regarding the comparison between groups and the detection of early markers of ASD, the current protocols and techniques may be considered valuable tools to investigate motor developmental trajectories in infants.