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Cry acoustics may be used to determine autism risk
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The pain-related cries of infants at risk for autism spectrum disorder had a higher and more variable fundamental frequency — or pitch — compared with the cries of low-risk infants, researchers reported. The study results may have implications for early diagnosis of the disorder.
“Because we can measure various aspects of babies’ cries from the earliest days of life, it may be possible to use this technique to identify risk for neurological problems such as autism long before we can detect behavioral differences,” study researcher Stephen J. Sheinkopf, PhD, assistant professor at The Warren Alpert Medical School of Brown University, said in a press release.
Sheinkopf and colleagues studied the acoustic characteristics of the cries of 21 infants at risk for autism spectrum disorder (ASD) and 18 low-risk infants. All high-risk infants in the study had at least one sibling with confirmed ASD diagnosis.
Audio-video recordings were made in the infants’ homes when they were aged 6 months. Excerpts of those recordings were then analyzed and the cries were categorized as either pain-related or non-pain-related. The researchers also accounted for the infants’ position and the context of the observed cries. The excerpts were then subjected to acoustic analysis using a computer program designed specifically for that purpose. The infants were followed up at 36 months.
Results indicated that at-risk infants produced pain-related cries with higher and more variable fundamental frequency vs. low-risk infants (P=.018). The pain-related cries of at-risk infants also had a greater range of fundamental frequency compared with low-risk infants (P=.058). Three at-risk infants were later diagnosed with ASD, two of whom had vocalizations that could be analyzed. One of the ASD cases had the second highest fundamental frequency in the entire sample, higher than all low-risk infants. The two ASD cases included in the analysis had the lowest average phonation in each of the pain-related and non-pain-related categories.
The researchers acknowledged limitations of the study, including the sample size, missing data and the use of other methods of characterizing fundamental frequency in previous research.
However, Sheinkopf concluded that “these findings demonstrate the potential of this approach for babies as young as 6 months of age.”
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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P. Gail Williams, MD
The analysis of cry acoustics in infants who are later diagnosed with autism as compared to controls is an important topic of study. A recent prospective study by Ozonoff et al (Pediatrics. 2011;128:e488-495) suggests that social behaviors in infants who later develop autism are very comparable to those of other infants at 6 months of age, but then take a downward trajectory. If differences exist in characteristic cries of these infants, these differences have the potential of being an early risk marker. Sheinkopf et al evaluated such acoustic variables as frequency, variability of frequency, phonation, and utterance duration in 21 infants (six male, 15 female) who had an older sibling diagnosed with ASD, as compared to a control group of low-risk infants. They noted that at-risk infants produced pain-related cries that had significantly higher mean frequency and greater range of frequency than the control group. There were no identified differences in non-pain-related cries.
This study has a number of limitations, the most obvious of which is the small number of infants; only two of whom went on to be diagnosed with ASD at 3 years of age. The authors also note missing developmental data and lack of standard methods to elicit cries. Nonetheless, the article raises some interesting issues for additional study, including analysis of additional acoustic measures, correlating linguistic functioning with cries, and looking at parent perceptions and interpretations of cries. Identification of markers that distinguish children at risk for ASD is a valuable endeavor, especially if it provides guidance regarding which children will benefit from intensive interventions that can optimize the neural connections shaping early brain development and learning and, perhaps, prevent deterioration in social communication skills.
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