Scholars@Duke
Kimberly Carpenter

Kimberly Carpenter

Associate Professor in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
kimberly.carpenter@duke.edu
DUMC 2737, Durham, NC 27710
2424 Erwin Road, Suite 501, Durham, NC 27705

Scholarly Works - Journal articles

Brief Report: Relationships Between Caregiver-Reported Externalizing and Internalizing Behaviors and the Modified Checklist for Autism in Toddlers.

Journal article J Autism Dev Disord · September 2026 PURPOSE: Early detection and intervention are associated with improved outcomes for autistic children. Thus, it is important to understand factors influencing early screening tools designed to detect autism. This study examined the relationship between car ... Full text Link to item Cite

The Influence of Sensory Processing on Executive Function in Young Autistic Children.

Journal article J Autism Dev Disord · July 15, 2026 PURPOSE: Differences in sensory responsivity and executive function are common in autistic individuals and impact daily functioning, however how they relate to one another in autistic children is unknown. We tested the hypothesis that differences in sensor ... Full text Link to item Cite

Cognitive Disengagement Syndrome in Young Autistic Children, Children with ADHD, and Autistic Children with ADHD.

Journal article J Clin Child Adolesc Psychol · 2026 OBJECTIVE: Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior ... Full text Link to item Cite

Assessment of Attention-Deficit/Hyperactivity Disorder in Young Autistic Children.

Journal article J Clin Child Adolesc Psychol · 2026 OBJECTIVE: Co-occurring attention-deficit/hyperactivity disorder (ADHD) is present for many autistic children and is associated with increased impairments, unique treatment needs, and decreased response to autism-specific interventions. Diagnosing ADHD in ... Full text Link to item Cite

Use of computer vision analysis for labeling inattention periods in EEG recordings with visual stimuli.

Journal article Sci Rep · August 22, 2025 Electroencephalography (EEG) recordings with visual stimuli require detailed coding to determine the periods of participant's attention. Here we propose to use a supervised machine learning model and off-the-shelf video cameras only. We extract computer vi ... Full text Link to item Cite

Pathways to health: A longitudinal examination of protective factors in children with and without preschool anxiety.

Journal article Dev Psychopathol · August 2025 Preschool anxiety is highly prevalent and well known to predict risk for future psychopathology. The present study explores whether a diagnosis of an anxiety disorder in preschool interacts with (a) social skills and (b) cognitive ability to longitudinally ... Full text Link to item Cite

Attentional and electrophysiological associations with executive function ability in young autistic children.

Journal article Sci Rep · July 10, 2025 Difficulties in executive functioning (EF) have been consistently reported in autistic individuals, but less is known about the attentional and neural mechanisms driving these difficulties. We explored the associations between EF abilities and sustained at ... Full text Link to item Cite

Autism Digital Phenotyping in Preschool- and School-Age Children.

Journal article Autism Res · June 2025 There is a critical need for scalable and objective tools for autism screening and outcome monitoring, which can be used alongside traditional caregiver and clinical measures. To address this need, we developed SenseToKnow, a tablet- or smartphone-based di ... Full text Link to item Cite

Identifying and Responding to Gaps in the Academic Research Pipeline: Findings From the International Society for Autism Research (INSAR) Early Career Committee.

Journal article Autism Res · April 2025 The International Society for Autism Research (INSAR) was established in 2001 with the purpose of providing researchers in the field of autism a specific venue to enhance the quality of multidisciplinary research and elevate the field among the sciences. T ... Full text Link to item Cite

Behavioral characteristics of toddlers later identified with an autism diagnosis, ADHD symptoms, or combined autism and ADHD symptoms.

Journal article J Child Psychol Psychiatry · February 2025 BACKGROUND: Autism commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of ... Full text Link to item Cite

Unique and shared influences of anxiety and ADHD on the behavioral profile of autism in early childhood.

Journal article Front Child Adolesc Psychiatry · 2025 INTRODUCTION: Autism is characterized by a wide range of core and associated behavioral features that can be influenced by co-occurring conditions such as attention-deficit hyperactivity disorder (ADHD) and anxiety disorders. Executive function difficultie ... Full text Link to item Cite

Model selection to achieve reproducible associations between resting state EEG features and autism.

Journal article Sci Rep · October 25, 2024 A concern in the field of autism electroencephalography (EEG) biomarker discovery is their lack of reproducibility. In the present study, we considered the problem of learning reproducible associations between multiple features of resting state (RS) neural ... Full text Link to item Cite

Automated Video Tracking of Autistic Children's Movement During Caregiver-Child Interaction: An Exploratory Study.

Journal article J Autism Dev Disord · October 2024 Objective, quantitative measures of caregiver-child interaction during play are needed to complement caregiver or examiner ratings for clinical assessment and tracking intervention responses. In this exploratory study, we examined the feasibility of using ... Full text Link to item Cite

Adaptive Behavior in Young Autistic Children: Associations with Irritability and ADHD Symptoms.

Journal article J Autism Dev Disord · September 2024 Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD sympto ... Full text Link to item Cite

Computer Vision Analysis of Caregiver-Child Interactions in Children with Neurodevelopmental Disorders: A Preliminary Report.

Journal article J Autism Dev Disord · June 2024 We report preliminary results of computer vision analysis of caregiver-child interactions during free play with children diagnosed with autism (N = 29, 41-91 months), attention-deficit/hyperactivity disorder (ADHD, N = 22, 48-100 months), or combined autis ... Full text Link to item Cite

Early life adversity and psychopathology in preschoolers: mechanisms and moderators.

Journal article Eur Child Adolesc Psychiatry · June 2024 Developmental theories suggest that exposure to early life adversity (ELA) alters developing emotional response systems, predicting risk for psychopathology across the life span. The present study examines whether negative emotionality (NE), a trait-like m ... Full text Link to item Cite

Automated movement tracking of young autistic children during free play is correlated with clinical features associated with autism.

Journal article Autism · November 2023 Play-based observations allow researchers to observe autistic children across a wide range of ages and skills. We recorded autistic children playing with toys in the center of a room and at a corner table while a caregiver remained seated off to the side a ... Full text Link to item Cite

Associations between executive function and attention abilities and language and social communication skills in young autistic children.

Journal article Autism · October 2023 Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in ex ... Full text Open Access Link to item Cite

Early detection of autism using digital behavioral phenotyping.

Journal article Nat Med · October 2023 Early detection of autism, a neurodevelopmental condition associated with challenges in social communication, ensures timely access to intervention. Autism screening questionnaires have been shown to have lower accuracy when used in real-world settings, su ... Full text Link to item Cite

Distinct Associations of Deprivation and Threat With Alterations in Brain Structure in Early Childhood.

Journal article J Am Acad Child Adolesc Psychiatry · August 2023 OBJECTIVE: The dimensional model of adversity and psychopathology hypothesizes deprivation and threat impact distinct neurobiological pathways, such as brain structure. This hypothesis has not been examined longitudinally or in young children. This study t ... Full text Link to item Cite

Relationship between quantitative digital behavioral features and clinical profiles in young autistic children.

Journal article Autism Res · July 2023 Early behavioral markers for autism include differences in social attention and orienting in response to one's name when called, and differences in body movements and motor abilities. More efficient, scalable, objective, and reliable measures of these beha ... Full text Link to item Cite

Associations of preschool reactive bed-sharing with sociodemographic factors, sleep disturbance, and psychopathology.

Journal article Child Adolesc Psychiatry Ment Health · May 17, 2023 OBJECTIVE: To advance understanding of early childhood bed-sharing and its clinical significance, we examined reactive bed-sharing rates, sociodemographic correlates, persistence, and concurrent and longitudinal associations with sleep disturbances and psy ... Full text Link to item Cite

Blink rate and facial orientation reveal distinctive patterns of attentional engagement in autistic toddlers: a digital phenotyping approach.

Journal article Sci Rep · May 3, 2023 Differences in social attention are well-documented in autistic individuals, representing one of the earliest signs of autism. Spontaneous blink rate has been used to index attentional engagement, with lower blink rates reflecting increased engagement. We ... Full text Link to item Cite

A tablet-based game for the assessment of visual motor skills in autistic children.

Journal article NPJ Digit Med · February 3, 2023 Increasing evidence suggests that early motor impairments are a common feature of autism. Thus, scalable, quantitative methods for measuring motor behavior in young autistic children are needed. This work presents an engaging and scalable assessment of vis ... Full text Open Access Link to item Cite

Exploring Complexity of Facial Dynamics in Autism Spectrum Disorder.

Journal article IEEE Trans Affect Comput · 2023 Atypical facial expression is one of the early symptoms of autism spectrum disorder (ASD) characterized by reduced regularity and lack of coordination of facial movements. Automatic quantification of these behaviors can offer novel biomarkers for screening ... Full text Link to item Cite

Complexity analysis of head movements in autistic toddlers.

Journal article J Child Psychol Psychiatry · January 2023 BACKGROUND: Early differences in sensorimotor functioning have been documented in young autistic children and infants who are later diagnosed with autism. Previous research has demonstrated that autistic toddlers exhibit more frequent head movement when vi ... Full text Link to item Cite

Shorter average look durations to dynamic social stimuli are associated with higher levels of autism symptoms in young autistic children.

Journal article Autism · August 2022 Many studies of autism look at the differences in how autistic research participants look at certain types of images. These studies often focus on where research participants are looking within the image, but that does not tell us everything about how much ... Full text Link to item Cite

Association of adversity with psychopathology in early childhood: Dimensional and cumulative approaches.

Journal article Depress Anxiety · June 2022 BACKGROUND: The association between adversity and psychopathology in adolescents and adults is characterized by equifinality. These associations, however, have not been assessed during early childhood when psychopathology first emerges. Defining adversity ... Full text Link to item Cite

Changes in the geometry and robustness of diffusion tensor imaging networks: Secondary analysis from a randomized controlled trial of young autistic children receiving an umbilical cord blood infusion.

Journal article Front Psychiatry · 2022 Diffusion tensor imaging (DTI) has been used as an outcome measure in clinical trials for several psychiatric disorders but has rarely been explored in autism clinical trials. This is despite a large body of research suggesting altered white matter structu ... Full text Link to item Cite

Distance from Typical Scan Path When Viewing Complex Stimuli in Children with Autism Spectrum Disorder and its Association with Behavior.

Journal article J Autism Dev Disord · October 2021 Eye-tracking is often used to study attention in children with autism spectrum disorder (ASD). Previous research has identified multiple atypical patterns of attention in children with ASD based on areas-of-interest analysis. Fewer studies have investigate ... Full text Open Access Link to item Cite

A scalable computational approach to assessing response to name in toddlers with autism.

Journal article J Child Psychol Psychiatry · September 2021 BACKGROUND: This study is part of a larger research program focused on developing objective, scalable tools for digital behavioral phenotyping. We evaluated whether a digital app delivered on a smartphone or tablet using computer vision analysis (CVA) can ... Full text Link to item Cite

Computational Methods to Measure Patterns of Gaze in Toddlers With Autism Spectrum Disorder.

Journal article JAMA Pediatr · August 1, 2021 IMPORTANCE: Atypical eye gaze is an early-emerging symptom of autism spectrum disorder (ASD) and holds promise for autism screening. Current eye-tracking methods are expensive and require special equipment and calibration. There is a need for scalable, fea ... Full text Link to item Cite

A lost generation? The impact of the COVID-19 pandemic on early career ASD researchers.

Journal article Autism Res · June 2021 Featured Publication The COVID-19 pandemic has disrupted autism research and services. Early career researchers (ECRs) are particularly vulnerable to the impact of the pandemic on job security and career development. The goal of this study was to capture the challenges ECRs ar ... Full text Link to item Cite

A Review of the Default Mode Network in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder.

Journal article Brain Connect · May 2021 Functional magnetic resonance imaging (fMRI) has been widely used to examine the relationships between brain function and phenotypic features in neurodevelopmental disorders. Techniques such as resting-state functional connectivity (FC) have enabled the id ... Full text Link to item Cite

Digital Behavioral Phenotyping Detects Atypical Pattern of Facial Expression in Toddlers with Autism.

Journal article Autism Res · March 2021 Featured Publication Commonly used screening tools for autism spectrum disorder (ASD) generally rely on subjective caregiver questionnaires. While behavioral observation is more objective, it is also expensive, time-consuming, and requires significant expertise to perform. As ... Full text Link to item Cite

Gastrointestinal problems are associated with increased repetitive behaviors but not social communication difficulties in young children with autism spectrum disorders.

Journal article Autism · February 2021 Individuals with autism spectrum disorder are more likely than typically developing individuals to experience a range of gastrointestinal abnormalities, including chronic diarrhea, constipation, food sensitivities, and abdominal pain. These gastrointestina ... Full text Link to item Cite

Computer Vision Analysis for Quantification of Autism Risk Behaviors.

Journal article IEEE Trans Affect Comput · 2021 Observational behavior analysis plays a key role for the discovery and evaluation of risk markers for many neurodevelopmental disorders. Research on autism spectrum disorder (ASD) suggests that behavioral risk markers can be observed at 12 months of age or ... Full text Link to item Cite

Impact of a digital Modified Checklist for Autism in Toddlers-Revised on likelihood and age of autism diagnosis and referral for developmental evaluation.

Journal article Autism · October 2020 This was a project in primary care for young children (1-2 years old). We tested a parent questionnaire on a tablet. This tablet questionnaire asked questions to see whether the child may have autism. We compared the paper and pencil version of the questio ... Full text Link to item Cite

A Six-Minute Measure of Vocalizations in Toddlers with Autism Spectrum Disorder.

Journal article Autism Res · August 2020 To improve early identification of autism spectrum disorder (ASD), we need objective, reliable, and accessible measures. To that end, a previous study demonstrated that a tablet-based application (app) that assessed several autism risk behaviors distinguis ... Full text Open Access Link to item Cite

Measuring robustness of brain networks in autism spectrum disorder with Ricci curvature.

Journal article Sci Rep · July 2, 2020 Ollivier-Ricci curvature is a method for measuring the robustness of connections in a network. In this work, we use curvature to measure changes in robustness of brain networks in children with autism spectrum disorder (ASD). In an open label clinical tria ... Full text Open Access Link to item Cite

The influence of background auditory noise on P50 and N100 suppression elicited by the paired-click paradigm

Journal article Journal of Psychophysiology · July 1, 2020 Auditory sensory gating is commonly assessed using the Paired-Click Paradigm (PCP), an electroencephalography (EEG) task in which two identical sounds are presented sequentially and the brain's inhibitory response to the second sound is measured. Many clin ... Full text Cite

A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder.

Journal article J Pediatr · July 2020 OBJECTIVE: To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD). STUDY DESIGN: This prospective, randomized, placebo-controlled, doubl ... Full text Open Access Link to item Cite

Relative Average Look Duration and its Association with Neurophysiological Activity in Young Children with Autism Spectrum Disorder.

Journal article Sci Rep · February 5, 2020 Autism Spectrum Disorder (ASD) is characterized by early attentional differences that often precede the hallmark symptoms of social communication impairments. Development of novel measures of attentional behaviors may lead to earlier identification of chil ... Full text Link to item Cite

Author Correction: Atypical postural control can be detected via computer vision analysis in toddlers with autism spectrum disorder.

Journal article Sci Rep · January 14, 2020 An amendment to this paper has been published and can be accessed via a link at the top of the paper. ... Full text Link to item Cite

Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children.

Journal article J Abnorm Child Psychol · June 2019 Featured Publication Anxiety disorders are prevalent and significantly impact young children and their families. One hypothesized risk factor for anxiety is heightened responses to sensory input. Few studies have explored this hypothesis prospectively. This study had two goals ... Full text Link to item Cite

Computer vision analysis captures atypical attention in toddlers with autism.

Journal article Autism · April 2019 To demonstrate the capability of computer vision analysis to detect atypical orienting and attention behaviors in toddlers with autism spectrum disorder. One hundered and four toddlers of 16-31 months old (mean = 22) participated in this study. Twenty-two ... Full text Link to item Cite

White Matter Tract Changes Associated with Clinical Improvement in an Open-Label Trial Assessing Autologous Umbilical Cord Blood for Treatment of Young Children with Autism.

Journal article Stem Cells Transl Med · February 2019 Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by social communication deficits and the presence of restricted interests and repetitive behaviors. We have previously reported significant improvements in behavior ... Full text Open Access Link to item Cite

Atypical postural control can be detected via computer vision analysis in toddlers with autism spectrum disorder.

Journal article Sci Rep · November 19, 2018 Evidence suggests that differences in motor function are an early feature of autism spectrum disorder (ASD). One aspect of motor ability that develops during childhood is postural control, reflected in the ability to maintain a steady head and body positio ... Full text Link to item Cite

Automatic emotion and attention analysis of young children at home: a ResearchKit autism feasibility study.

Journal article NPJ Digit Med · 2018 Current tools for objectively measuring young children's observed behaviors are expensive, time-consuming, and require extensive training and professional administration. The lack of scalable, reliable, and validated tools impacts access to evidence-based ... Full text Open Access Link to item Cite

Use of a Digital Modified Checklist for Autism in Toddlers - Revised with Follow-up to Improve Quality of Screening for Autism.

Journal article J Pediatr · April 2017 OBJECTIVES: To assess changes in quality of care for children at risk for autism spectrum disorders (ASD) due to process improvement and implementation of a digital screening form. STUDY DESIGN: The process of screening for ASD was studied in an academic p ... Full text Link to item Cite

Magnetic susceptibility of brain iron is associated with childhood spatial IQ.

Journal article Neuroimage · May 15, 2016 Iron is an essential micronutrient for healthy brain function and development. Because of the importance of iron in the brain, iron deficiency results in widespread and lasting effects on behavior and cognition. We measured iron in the basal ganglia of you ... Full text Link to item Cite

Quantifying Risk for Anxiety Disorders in Preschool Children: A Machine Learning Approach.

Journal article PLoS One · 2016 Featured Publication Early childhood anxiety disorders are common, impairing, and predictive of anxiety and mood disorders later in childhood. Epidemiological studies over the last decade find that the prevalence of impairing anxiety disorders in preschool children ranges from ... Full text Link to item Cite

Psychological and Psychosocial Impairment in Preschoolers With Selective Eating.

Journal article Pediatrics · September 2015 OBJECTIVE: We examined the clinical significance of moderate and severe selective eating (SE). Two levels of SE were examined in relation to concurrent psychiatric symptoms and as a risk factor for the emergence of later psychiatric symptoms. Findings are ... Full text Link to item Cite

Preschool anxiety disorders predict different patterns of amygdala-prefrontal connectivity at school-age.

Journal article PLoS One · 2015 Featured Publication OBJECTIVE: In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an explora ... Full text Open Access Link to item Cite

A scalable app for measuring autism risk behaviors in young children: A technical validity and feasibility study

Journal article Proceedings of the 5th EAI International Conference on Wireless Mobile Communication and Healthcare · 2015 Link to item Cite

Questionnaire simplification for fast risk analysis of children's mental health

Journal article ICASSP IEEE International Conference on Acoustics Speech and Signal Processing Proceedings · January 1, 2014 Early detection and treatment of psychiatric disorders on children has shown significant impact in their subsequent development and quality of life. The assessment of psychopathology in childhood is commonly carried out by performing long comprehensive int ... Full text Cite

The neural circuitry of autism.

Journal article Neurotox Res · October 2011 Autism is a complex neurodevelopmental disorder, characterized by deficits in social emotional, and language domains, as well as repetitive restrictive behaviors. The vast heterogeneity of the clinical and behavioral symptoms has made it rather difficult t ... Full text Link to item Cite

The benefit of directly comparing autism and schizophrenia for revealing mechanisms of social cognitive impairment.

Journal article J Neurodev Disord · June 2011 Autism and schizophrenia share a history of diagnostic conflation that was not definitively resolved until the publication of the DSM-III in 1980. Though now recognized as heterogeneous disorders with distinct developmental trajectories and dissociative fe ... Full text Open Access Link to item Cite

Attention deficits in schizophrenia--preliminary evidence of dissociable transient and sustained deficits.

Journal article Schizophr Res · September 2010 Attention deficits are considered to be fundamental in patients with schizophrenia. During attention tasks, patients with schizophrenia have been shown to display increased brain activity in some neuroimaging studies but reduced brain activity in others. T ... Full text Link to item Cite