Autism spectrum disorders (ASD) are pervasive developmental disorders characterized by impairments in social interaction and communication and the presence of repetitive behaviors and restricted interests (
1,
2). In addition to these well-described hallmarks of ASD, there also exists substantial evidence for atypicalities in visual perception (e.g.,
3–
5) and auditory perception (e.g.,
6,
7). Most notably, in the visual domain, it is well known that individuals with ASD often exhibit impairments in tests of face perception (e.g.,
8–
10, see
11,
12 for reviews), and abnormal cortical responses to pictures of faces (e.g.,
13–
18 but cf.
19). In contrast to these reported impairments in face processing, there are several reports that young children with ASD show normal or even enhanced processing of non-face objects (e.g.,
20–
25).
Most relevant to the current study, a number of event-related potential (ERP) studies have documented atypical cortical responses to faces vs. objects in individuals with ASD. In typical adults, there is a face sensitive ERP component, the N170, recorded over occipital and temporal scalp locations, which is consistently larger and faster in response to face vs. objects (e.g.,
26–
28). By contrast, in adults with ASD, the N170 has been shown to exhibit the reverse pattern, i.e., faster responses to objects than faces, and direct group comparisons show that N170 responses to faces are slower in ASD, than in typical, adults (
29). Atypicalities have also been reported in children with ASD. In typical infants/children, there are two components that have each shown some degree of face sensitivity: the N290 and the P400 (
30–
32), which are thought to merge together during development to produce the adult N170 (
31,
33). Like the results from adults with ASD, the N290 face/object responses of 3- to 4-year old children with ASD have been shown to differ from those of typically developing children (
34). While the N290 of typical children shows faster responses to faces than objects, the N290 of children with ASD shows faster responses to objects than faces. And, direct group comparisons show that N290 responses to faces are slower in ASD, than in typical, children. In addition to atypicalities in face vs. object processing, the results of the above-described adult/children studies show less hemispheric asymmetry of the N170/N290 amplitude (data collapsed across faces and objects) in ASD, than in typical, individuals. In sum, these ERP studies reveal atypical face vs. object processing, and atypical hemispheric processing, in ASD, which can be observed by three years of age.
Although there is no clear consensus about the origins of face/object atypicalities in ASD (see
35,
36), there is speculation that they are
genetically-mediated. In support of this possibility are studies showing atypical face processing in first-degree family members of individuals with ASD, specifically, parents of children with ASD (
37,
38, and see
39 for commentary), and siblings of children with ASD (mean age ~12 years,
40,
41, but see
42). Because of the strong (but complex) genetic contribution in ASD, these family members are likely to carry some of the genes associated with ASD, and thus their face processing atypicality is believed to reflect a genetic predisposition that runs in families of ASD. Recently, the concept of an “endophenotype” in ASD has emerged to refer to a measurable trait (like face processing atypicality) that occurs more commonly in both individuals with ASD and their family members (i.e., without ASD) than in the general population (e.g.,
43,
44 and see
45 for a more comprehensive description of the term and its relevance in other disorders). Note that while an endophenotype is considered a genetically-mediated risk factor for a disorder, by definition, its presence alone is not thought to correlate with the presence of the disorder. With this in mind, there are several ways that an endophenotype could be associated with development of ASD. First, it may be that an endophenotype is more severe in individuals with ASD than in family members without ASD. This notion is consistent with the report of milder versions of the hallmarks of ASD in family members, referred to as the “broader autism phenotype” (see
46–
49). Second, the severity of an endophenotype may be similar between individuals with ASD and their family members without ASD, but what leads to the development of ASD is an inability to compensate for the endophenotype (often referred to as “lack of resilience” in the developmental disorder literature, see
50,
51 for reviews). This lack of compensation could be in the form of being deficient in some critical biological protection factor (e.g., hormones or a particular gene) or an inability to compensate at the behavioral level (e.g., because of a personality trait or temperament). Third, developing ASD may result from possessing a critical number of different endophenotypes, even if each on its own is mild.
Given that atypical face/object processing is an endophenotype in ASD, it is of interest to determine when in development it emerges. To this end, we tested face/object processing in 10-month-old “High-Risk” infants, i.e., infant siblings of children diagnosed with ASD (see
52–
54). Their risk of developing ASD, 5 – 10% (
55,
56), is roughly 10- to 20-fold higher than that seen in the general population, 0.2 – 0.6% (
57,
58). And, as explained above, even High-Risk infants who never develop ASD are likely to exhibit differences compared to controls, i.e., “Low-Risk” infants from families without history of ASD. Indeed, several studies of High-Risk infants (who were known to not have developed ASD or were too young to be tested for ASD) have shown that they differ from Low-Risk infants in visual responses (
23,
59–
61), motor activity (
62,
63), social interactions (
64–
70), and language skills (
62,
68,
69,
71–
73). And, High-Risk infants who do go on to develop ASD often exhibit more severe atypicalities on these same measures (visual responses: 23, 53, motor activity: 53, 74, social interactions: 53, 75 and language skills: 53, 72–74, 76, 77).
In the current study, we used the same ERP paradigm employed in previous studies of adults and children with ASD (
29,
34) and parents of children with ASD (
37). Like these previous studies, our results reveal atypical face vs. object processing, and atypical hemispheric processing, in 10-month-old infants at genetic risk for developing ASD, revealing potential endophenotypes for ASD early in development.