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Are early visual behavior impairments involved in the onset of autism spectrum disorders? Insights for early diagnosis and intervention

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Abstract

A correct use of the visual behavior (VB), and its integration with motor function, represents the earliest mean used by infants to explore and act on the social and non-social surrounding environment. The aim of this mini review is to present influential evidence of abnormalities in the VB domain in ASD individuals and to discuss the implication of these findings for early identification and intervention. We analyzed the possible anomalies in oculomotor abilities, visual attention, and visual-motor integration, as parts of a wider visual behavior defect, that could affect children with autism spectrum disorders (ASD) since the early stages of development.

Conclusion: According to the literature, difficulties in these three areas have been often reported in children with ASD, and the visual-perception deficit could have cascading effects on learning processes and on social development. Despite this evidence of atypical VB in ASD, their investigation is not yet included into diagnostic processes, and they are not yet considered a specific treatment target.

What is Known:

•Atypical social use of visual behavior is one the first symptoms in children with autism spectrum disorders

•Individuals with autism spectrum disorders often show unusual visual exploration of the surrounding environment

What is New:

•It is possible to hypothesize that early visual behavior abnormalities may affect experiences that permit learning processes and social and communicative development in infants

•An early assessment of visual behavior, as a core symptom of ASD, might improve the diagnostic processes and might help to developing more individualized treatments.

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Abbreviations

ASD:

Autism spectrum disorders

ADOS-2:

Autism Diagnostic Observation Schedule-2

BAP:

Broader autism phenotype

f-MRI:

Functional-magnetic resonance imaging

IJA:

Initiation of joint attention

RJA:

Response to joint attention

TD:

Typical development (adolescents or children)

VB:

Visual Behavior

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Authors and Affiliations

  1. Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, viale del Tirreno 331, Calambrone, Pisa, Italy

    Fabio Apicella, Valeria Costanzo & Giulia Purpura

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  1. Fabio Apicella
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  2. Valeria Costanzo
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  3. Giulia Purpura
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Contributions

FA had the primary responsibility for the analysis of literature and for writing the manuscript. VC participated in the development of the theoretical framework and contributed to the writing of the manuscript. GP was responsible for the idea of this mini review, supervised the design and execution of the review and contributed to the writing of the manuscript for the final version. All authors reviewed the final manuscript.

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Correspondence to Giulia Purpura.

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Communicated by Peter de Winter

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Apicella, F., Costanzo, V. & Purpura, G. Are early visual behavior impairments involved in the onset of autism spectrum disorders? Insights for early diagnosis and intervention. Eur J Pediatr 179, 225–234 (2020). https://doi.org/10.1007/s00431-019-03562-x

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