Background
Restricted and repetitive behaviors (RRBs), detectable by 12 months
(mo) in many infants later diagnosed with autism spectrum disorder (ASD),
may represent some of the earliest behavioral markers of ASD. However, brain
function underlying the emergence of these key behaviors remains
unknown.
Methods
Behavioral and resting-state functional connectivity (fc) magnetic
resonance imaging data were collected from 167 children at high and low
familial risk for ASD at 12 and 24mo (n=38 at both time points). Twenty
infants met criteria for ASD at 24 mo. We divided RRBs intofour
subcategories (restricted, stereotyped, ritualistic/sameness,
self-injurious) and used a data-driven approach to identify functional brain
networks associated with the development of each RRB subcategory.
Results
Higher scores for ritualistic/sameness behavior were associated with
less positive fc between visual and control networks at 12 and 24 mo.
Ritualistic/sameness and stereotyped behaviors were associated with less
positive fc between visual and default mode networks at 12 mo. At 24 mo,
stereotyped and restricted behaviors were associated with more positive fc
between default mode and control networks. Additionally, at 24 mo,
stereotyped behavior was associated with more positive fc between dorsal
attention and subcortical networks, while restricted behavior was associated
with more positive fc between default mode and dorsal attention networks. No
significant network-level associations were observed for self-injurious
behavior.
Conclusion
These observations mark the earliest known description of functional
brain systems underlying RRBs, reinforce the construct validity of RRB
subcategories in infants, and implicate specific neural substrates for
future interventions targeting RRBs.