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Modeling the Autism Spectrum Disorder Phenotype

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Abstract

Autism Spectrum Disorder (ASD) is highly heritable, and although there has been active research in an attempt to discover the genetic factors underlying ASD, diagnosis still depends heavily on behavioral assessments. Recently, several large-scale initiatives, including those of the Autism Consortium, have contributed to the collection of extensive information from families affected by ASD. Our goal was to develop an ontology that can be used 1) to provide improved access to the data collected by those who study ASD and other neurodevelopmental disorders, and 2) to assess and compare the characteristics of the instruments that are used in the assessment of ASD. We analyzed two dozen instruments used to assess ASD, studying the nature of the questions asked and items assessed, the method of delivery, and the overall scope of the content. These data together with the extensive literature on ASD contributed to our iterative development of an ASD phenotype ontology. The final ontology comprises 283 concepts distributed across three high-level classes, ‘Personal Traits’, ‘Social Competence’, and ‘Medical History’. The ontology is fully integrated with the Autism Consortium database, allowing researchers to pose ontology-based questions. The ontology also allows researchers to assess the degree of overlap among a set of candidate instruments according to several objective criteria. The ASD phenotype ontology has promise for use in research settings where extensive phenotypic data have been collected, allowing a concept-based approach to identifying behavioral features of importance and for correlating these with genotypic data.

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Notes

  1. Note that the sum of the normalized questions in the three major branches is slightly higher than the number reported for the overall ontology. That is because in a few instances questions are mapped to concepts in more than one branch of the ontology. A question from CCC-2 illustrates: “moves the conversation to a favorite topic, even if others do not seem interested”. This question has to do with ‘Conversational Skills’ (found in the ‘Social Competence’ branch), and also relates to ‘Restricted and Unusual Interests’ (found in the ‘Personal Traits’ branch).

  2. Because a major branch of our ontology involves medical history, and because most ASD assessment instruments have few or no medical history concepts, we applied the objective measures only to combinations of instruments that included the Medical History (MH) assessment. This is on the assumption that in most research and clinical settings an instrument similar in coverage to the Autism Consortium Medical History assessment would be used.

  3. The concept is represented in the three instruments as “Self-Injury” (ADI-R), “Self-Injurious Behavior” (ADOS, RBS-R), and “Displays behaviors that cause injury to self” (VABS-II).

  4. ADI-R limits assessment to self-injurious behavior that “results in tissue damage”; RBS-R’s “Self-Injurious Behavior Subscale” includes measurements for specific acts “Hits self with body part”, “Hits self against surface or object”, “Hits self with object”, “Bites self”, “Pulls”, “Rubs or scratches self”, “Inserts finger or object”, and “Skin picking”.

  5. It may be that there are some instruments that are of interest to an investigator that are not included in the set used by the Autism Consortium. It should be relatively straightforward to map these additional instruments to the ontology, since we have provided definitions for each of the concepts in the ontology.

  6. It is important to note that unlike Wall et al. 2012 who propose using a small number of questions for diagnosing ASD, we are proposing a method for determining the best set of instruments that will cover the conceptual landscape of ASD, with a focus primarily on the research landscape where a goal of expanded data collection may need to be balanced with minimizing the investment of time and resources. It is possible that our methods might have implications for the future development of a comprehensive ASD instrument that can be administered in a shorter period of time, but that awaits further experimentation and validation.

  7. There may well be additional criteria for instrument selection that are independent of the criteria we have elucidated, including, among other things, whether the individual who is being tested has already had a full diagnostic workup, whether the research team already has experience with an instrument or set of instruments, and whether the expertise needed to administer an instrument is readily available or not within that setting.

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Acknowledgments

The authors were supported in part by grants from an Anonymous Foundation, the Autism Consortium, and the Harvard Clinical and Translational Science Center (NIH/NCRR UL1 RR025758-01). The authors thank Juliane Schneider and Cecilia Vernes for their contributions to the ontology and the team at MGH who developed the Autism Consortium database, including David Pauls and Julia O’Rourke.

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McCray, A.T., Trevvett, P. & Frost, H.R. Modeling the Autism Spectrum Disorder Phenotype. Neuroinform 12, 291–305 (2014). https://doi.org/10.1007/s12021-013-9211-4

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