A major donation now enables researchers at Karolinska Institutet and Uppsala University to follow children's development from infancy to ten years of age. The long-term project called Early Autism/ADHD Sweden (EASE) combines several advanced research methods and has already contributed new knowledge about early signs of autism and ADHD. The extension now makes it possible to examine how children's development changes over time.
How do autism and ADHD present early in life, and how are early signs linked to children's later development? These are questions that researchers have been studying within the EASE study since 2011. The project is a long-term research collaboration between the Center of Neurodevelopmental Disorders (KIND) at Karolinska Institutet and the DIVE lab at the Department of Psychology, Uppsala University.
Today, when early symptoms become a concern, parents are often told that they are not yet clear enough for a diagnosis, and that development therefore needs to be followed over time. In the EASE study researchers follow children who have a close relative with autism or ADHD, which means an increased likelihood of receiving a diagnosis. At the same time, most children who take part do not receive a diagnosis themselves. This makes it possible to study both typical development and early deviations within the same research framework.
"The EASE study is one of the most extensive and long-running research programmes in Sweden in this field. What makes the project special is that we follow children from the very first months of life and combine many different methods," says Terje Falck‑Ytter , Professor of Psychology at Uppsala University and research group leader at KIND, Karolinska Institutet.
The researchers collect behavioural data and carry out clinical assessments, and also use methods such as eye tracking, pupil measurements, EEG and magnetic resonance imaging (MRI) of the brain. As part of the project, the gut microbiota is also studied, with the aim of investigating whether it influences early brain development. By collecting data at repeated time points, the researchers can study how development unfolds over time, and the material is also analysed in international collaborations.
Early patterns of attention and perception
The project has already contributed several important research findings. One study showed that infants who are later diagnosed with autism follow other people's gaze just as well as other children, but are less likely to initiate joint attention themselves at ten months of age.
"This may point to an early reduction in social motivation, rather than a difficulty in perceiving other people's gaze or intentions," says Terje Falck‑Ytter.
Other earlier studies within the project have shown that three-year-old children with autism have a particularly strong ability to detect visual details in complex images, something that has previously mainly been described in older children and adults. Researchers within the project have also found that infants who later receive an autism diagnosis may show stronger pupil reactions to changes in light and to everyday, non-social sounds. Together, these findings suggest that biologically based differences in attention and sensory processing are present early in life.
"Several of our findings relate to how the brain responds early on to quite basic physical input from the environment, such as visual and auditory stimuli. This gives us clues about mechanisms that may influence children's continued development," says Terje.
The project includes both autism and ADHD, and analyses of development related to ADHD are ongoing within the long-term follow-up.
How stable are early diagnoses over time?
A donation of SEK 10 million over five years from the Marianne and Marcus Wallenberg Foundation now makes it possible to follow the children up to ten years of age. The extension means that researchers can study how stable early diagnoses are, and whether some children change their developmental trajectory during childhood.
"One major question is whether there may be subgroups among children with autism, for example children who develop symptoms later in childhood. This is one of the things we can now investigate," says Terje Falck‑Ytter.
The extension also provides opportunities to develop AI-based tools to predict diagnoses at ten years of age based on clinical data collected at three years of age. In addition, researchers can analyse whether measures from infancy - such as brain activity, eye movements and behaviour - are associated with later development.
