Frontal EEG Asymmetry As an Early Marker of Behavior Vulnerability in Infants with Congenital Visual Impairment Who Are at Risk of Autism Spectrum Disorder (ASD)

Background: Young children with congenital visual impairment (VI) are at increased risk of behavioral vulnerabilities. Previous literature on other clinical ‘at risk’ populations including young children with autism spectrum disorder (ASD) suggests that frontal electroencephalogram (EEG) asymmetry may be a marker of risk in temperament and behavior. Objectives: This study set out to investigate frontal EEG asymmetry at one year of age, behavior patterns at two years of age and their predictive associations. Methods: At Time 1, 22 infants (mean age 13 ± 2.5 months) with ‘potentially simple’ congenital disorders of the peripheral visual system underwent 128-channel EEG recording whilst being presented with happy, sad and neutral vocalizations. Frontal EEG asymmetry ratios were calculated from power spectral density values in the alpha frequency band (6-10 Hz), and a composite frontal EEG asymmetry score was derived. At Time 2, when the infants were approximately 2 years old, parent-rated behavior questionnaire (Achenbach Child Behavior Checklist) data was obtained. Results: The majority of the sample (63.6%) had greater left frontal asymmetry; 22.6% of the sample had clinical/subclinical range ‘internalizing’ behavior difficulties. Infants with the lowest vision levels (towards light perception at best or no vision) had significantly higher scores in the direction of behavior problems, specifically for Withdrawn problems. Longitudinal correlational analyses revealed a significant association between EEG frontal asymmetry and behavior, whereby greater left frontal asymmetry correlated with greater internalizing (emotionally reactive) problems. Conclusions: The finding of greater left frontal asymmetry in this sample of young children with VI is consistent with reports of greater left frontal asymmetry in other ‘at risk’ clinical populations including ASD (Gabard-Durnam et al., 2015). Our findings suggest the existence of a potential early electrophysiological marker of behavioral difficulties in young children with VI and later VI-ASD diagnosis, which is currently being explored.