. 2025 Mar 14;17(1):12.

doi: 10.1186/s11689-025-09599-4.

Disrupted visual attention relates to cognitive development in infants with Neurofibromatosis Type 1

Jannath Begum-Ali¹, Luke Mason², Tony Charman³, Mark H Johnson^{4

5}, Jonathan Green⁶, Shruti Garg⁶, Emily J H Jones^{7

8

9}; and the STAARS and EDEN Teams

Collaborators, Affiliations

Affiliations

¹ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK. jannath.begum.ali@bbk.ac.uk.
² Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK.
³ Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK.
⁴ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK.
⁵ Department of Psychology, University of Cambridge, Cambridge, UK.
⁶ Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
⁷ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK. e.jones@bbk.ac.uk.
⁸ Centre for Developmental Neurobiology, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK. e.jones@bbk.ac.uk.
⁹ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK. e.jones@bbk.ac.uk.

PMID: 40087579
PMCID: PMC11907931
DOI: 10.1186/s11689-025-09599-4

Disrupted visual attention relates to cognitive development in infants with Neurofibromatosis Type 1

Jannath Begum-Ali et al. J Neurodev Disord. 2025.

. 2025 Mar 14;17(1):12.

doi: 10.1186/s11689-025-09599-4.

Authors

Jannath Begum-Ali¹, Luke Mason², Tony Charman³, Mark H Johnson^{4

5}, Jonathan Green⁶, Shruti Garg⁶, Emily J H Jones^{7

8

9}; and the STAARS and EDEN Teams

Affiliations

¹ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK. jannath.begum.ali@bbk.ac.uk.
² Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK.
³ Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK.
⁴ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK.
⁵ Department of Psychology, University of Cambridge, Cambridge, UK.
⁶ Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
⁷ Centre for Brain and Cognitive Development, School of Psychological Sciences, Faculty of Science, Henry Wellcome Building, Birkbeck, University of London, Malet Street, London, UK. e.jones@bbk.ac.uk.
⁸ Centre for Developmental Neurobiology, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK. e.jones@bbk.ac.uk.
⁹ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King'S College London, London, UK. e.jones@bbk.ac.uk.

PMID: 40087579
PMCID: PMC11907931
DOI: 10.1186/s11689-025-09599-4

Abstract

Background: Neurofibromatosis Type 1 is a genetic condition diagnosed in infancy that substantially increases the likelihood of a child experiencing cognitive and developmental difficulties, including Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Children with NF1 show clear differences in attention, but whether these differences emerge in early development and how they relate to broader difficulties with cognitive and learning skills is unclear. To address this question requires longitudinal prospective studies from infancy, where the relation between domains of visual attention (including exogenous and endogenous shifting) and cognitive development can be mapped over time.

Methods: We report data from 28 infants with NF1 tested longitudinally at 5, 10 and 14 months compared to cohorts of 29 typical likelihood infants (with no history of NF1 or ASD and/or ADHD), and 123 infants with a family history of ASD and/or ADHD. We used an eyetracking battery to measure both exogenous and endogenous control of visual attention.

Results: Infants with NF1 demonstrated intact social orienting, but slower development of endogenous visual foraging. This slower development presented as prolonged engagement with a salient stimulus in a static display relative to typically developing infants. In terms of exogenous attention shifting, NF1 infants showed faster saccadic reaction times than typical likelihood infants. However, the NF1 group demonstrated a slower developmental improvement from 5 to 14 months of age. Individual differences in foraging and saccade times were concurrently related to visual reception abilities within the full infant cohort (NF1, typical likelihood and those with a family history of ASD/ADHD).

Conclusions: Our results provide preliminary evidence that alterations in saccadic reaction time and visual foraging may contribute to learning difficulties in infants with NF1.

Keywords: Attention deficit hyperactivity disorder; Autism spectrum disorder; Eye tracking; Longitudinal; Neurofibromatosis Type 1; Visual attention.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Informed written consent was provided by the parent(s) prior to the commencement of the study. The testing only took place if the infants were in a content and alert state. Ethical approval was granted by the National Research Ethics Service and the Research Ethics Committee of the Department of Psychological Sciences, Birkbeck, University of London. Consent for publication: Not applicable. Competing interests: Dr Jannath Begum Ali declares no conflict of interest. Dr Luke Mason declares no conflict of interest. Professor Tony Charman has served as a paid consultant to F. Hoffmann-La Roche Ltd and Servier. He has received royalties from Sage Publications and Guildford Publications. . Dr Shruti Garg declares no conflict of interest. Professor Jonathan Green declares no conflict of interest. Professor Mark H. Johnson declares no conflict of interest. Professor Emily J.H. Jones declares no conflict of interest. The STAARS team declares no conflict of interest. The EDEN team declares no conflict of interest.

Figures

**Fig. 1**
Consort diagram of data availability across measures and timepoint

**Fig. 2**
Illustration of the two key variables used in the current study

**Fig. 3**
Exogenous attention shifting measured using the gap-overlap task in the NF1 and TD groups. Left: Changes in reaction time with age at a group level; Right: Trajectories of change in reaction times by age in days

**Fig. 4**
Endogenous attention measured using the Popout task in the NF1 and TD groups. Left: Changes in face orienting and proportion looking to face with age at a group level; Right: Trajectories of change in proportion looking to faces by age in days

See this image and copyright information in PMC

References

1. Abdolrahmani M, Lyamzin DR, Aoki R, Benucci A. Attention separates sensory and motor signals in the mouse visual cortex. Cell Rep. 2021;36(2): 109377. 10.1016/j.celrep.2021.109377. - PubMed
1. Beaussart ML, Barbarot S, Mauger C, Roy A. Systematic review and meta-analysis of executive functions in preschool and school-age children with neurofibromatosis type 1. J Int Neuropsychol Soc. 2018;24(9):977–94. - PubMed
1. Begum-Ali, J., Kolesnik-Taylor, A., Quiroz, I., Mason, L., Garg, S., Green, J., Johnson, M. H., Jones, E. J. H., & STAARS and EDEN Teams. Early differences in auditory processing relate to Autism Spectrum Disorder traits in infants with Neurofibromatosis Type I. J Neurodev Disord. 2021;13(1):22. 10.1186/s11689-021-09364-3. - PMC - PubMed
1. Begum-Ali J, Goodwin A, Mason L, Pasco G, Charman T, Johnson MH, et al. Altered theta–beta ratio in infancy associates with family history of ADHD and later ADHD-relevant temperamental traits. J Child Psychol Psychiatry. 2022;63(9):1057–67. - PMC - PubMed
1. Begum-Ali J, Gossé LK, Mason L, Pasco G, Charman T, Johnson MH, et al. Infant sleep predicts trajectories of social attention and later autism traits. J Child Psychol Psychiatry. 2023;64(8):1200–11. - PMC - PubMed

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Disrupted visual attention relates to cognitive development in infants with Neurofibromatosis Type 1

Collaborators

Affiliations

Disrupted visual attention relates to cognitive development in infants with Neurofibromatosis Type 1

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous