Social and Communication Development in Toddlers With Early and Later Diagnosis of Autism Spectrum Disorders

Johns Hopkins University, Baltimore, Maryland, United States
Archives of General Psychiatry (Impact Factor: 14.48). 08/2007; 64(7):853-64. DOI: 10.1001/archpsyc.64.7.853
Source: PubMed


To our knowledge, no prospective studies of the developmental course of early and later diagnosis of autism spectrum disorders from 14 months of age exist.
To examine patterns of development from 14 to 24 months in children with early and later diagnosis of autism spectrum disorders.
Prospective, longitudinal design in which 125 infants at high and low risk for autism were tested from age 14 to 36 months. Comprehensive standardized assessments included measures of social, communication, and play behavior.
Testing occurred at a major medical and research institution as part of a large, ongoing longitudinal study.
Low-risk controls (n = 18) and siblings of children with autism, grouped on the basis of outcome diagnostic classification at 30 or 36 months: autism spectrum disorders (early diagnosis, n = 16; later diagnosis, n = 14), broader autism phenotype (n = 19), and non-broader autism phenotype (n = 58).
Social, communication, and symbolic abilities were assessed.
Social, communication, and play behavior in the early-diagnosis group differed from that in all other groups by 14 months of age. By 24 months, the later-diagnosis group differed from the non-autism spectrum disorder groups in social and communication behavior, but not from the early-diagnosis group. Examination of growth trajectories suggests that autism may involve developmental arrest, slowing, or even regression.
This study provides insight into different patterns of development of children with early vs later diagnosis of autism spectrum disorders.

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Available from: Rebecca Landa, Apr 03, 2014
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    • "Overall, our results suggest that reduced expression of positive affect may be an informative early risk marker for ASD, but that differences in this behavioural domain are not evident until later in the first year of life, and are specific to rate of smiling rather than duration of smiles produced. Our results regarding the timing of emergence of atypical expression of positive affect in ASD are consistent with most previous findings from prospective studies of ASD (e.g., Bryson et al. 2007; Landa et al. 2007; Zwaigenbaum et al. 2005) and some findings using retrospective research methods (e.g., Baranek 1999; Dawson et al. 2000). However , contrary to other retrospective studies (e.g., Maestro et al. 2002), we did not find support for the emergence of ASD-related differences in the expression of positive affect by 6 months of age. "
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    ABSTRACT: Research on the expression of positive affect in young children with Autism Spectrum Disorder (ASD) suggests that differences in this domain emerge late in the first year or early in the second year. However, many previous studies in this area employed retrospective research methods and global rating schemes. In the current study, the expression of positive affect was examined prospectively at ages 6, 12, and 18 months in three groups: infant siblings with ASD, infant siblings without ASD, and low-risk comparison infants. Infant siblings were the younger brothers or sisters of children diagnosed with ASD and, therefore, had a higher familial risk of ASD. The frequency and duration of smiles were coded from video excerpts from the Autism Observation Scale for Infants (Bryson, Zwaigenbaum, McDermott, Rombough, and Brian 2008), a standardized, play-based assessment of early signs of ASD. Results indicated that at 12 months, infant siblings with ASD had a lower rate of smiling than the other two groups. At 18 months, infant siblings with ASD continued to display a lower rate of smiling than infant siblings without ASD, but not comparison infants. Overall, these results indicate that infant siblings with ASD demonstrate less positive affect than infant siblings without ASD and low-risk comparison infants at 12 months. This suggests that reduced smiling may be an informative behavioural risk marker for ASD by children's first birthdays and may have implications for our understanding of atypical social development in children with ASD.
    Journal of Abnormal Child Psychology 08/2014; 43(3). DOI:10.1007/s10802-014-9921-6 · 3.09 Impact Factor
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    • "For all groups, neural responses to faces differed from neural responses to control visual stimuli , suggesting that more basic aspects of face processing are intact early in life in those infants who develop autism symptoms. Behavioral measures of gaze following seem typical around 6 months of age in Sib-A, but impairments become apparent at the beginning of the second year, when Sib-A follow gaze but spend less time than controls looking at the gazed-at object (Bedford et al., 2012; Landa, Holman, & Garrett-Mayer, 2007). It is still unknown whether difficulties with processing gaze measured at 6 months (Elsabbagh, Mercure, et al., 2012) reflect impaired STS functioning, or STS connectivity with other areas. "
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    ABSTRACT: A fast growing field, the study of infants at risk because of having an older sibling with autism (i.e. infant sibs) aims to identify the earliest signs of this disorder, which would allow for earlier diag-nosis and intervention. More importantly, we argue, these studies offer the opportunity to validate existing neuro-developmental models of autism against experimental evidence. Although autism is mainly seen as a disorder of social interaction and communica-tion, emerging early markers do not exclusively reflect impairments of the ''social brain''. Evidence for atypical development of sensory and attentional systems highlight the need to move away from localized deficits to models suggesting brain-wide involvement in autism pathology. We discuss the implications infant sibs findings have for future work into the biology of autism and the development of interventions. Ó 2014 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( licenses/by/3.0/).
    Developmental Review 06/2014; DOI:10.1016/j.dr.2014.05.003 · 3.23 Impact Factor
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    • "For example, in one study examining developmental regression, 35% of parents of children later diagnosed with ASD reported that their child was asymptomatic at 10-12 months of age (Werner, et al., 2005). In addition, a prospective study with a high-risk sample of children demonstrated that 46% of children diagnosed with ASD at 24 months of age showed no obvious symptoms of ASD at 14 months (Landa, et al., 2007). These findings point to the likelihood that screening for ASD risk at very early ages would be expected to miss some children who later develop the disorder. "
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    ABSTRACT: The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory-regulatory and social-communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of age from a community sample whose parents completed the First Year Inventory when their children were 12 months old. Parents of all 699 children completed the Social Responsiveness Scale-Preschool version and the Developmental Concerns Questionnaire to determine age 3 developmental outcomes. In addition, children deemed at risk for autism spectrum disorder based on liberal cut points on the First Year Inventory, Social Responsiveness Scale-Preschool, and/or Developmental Concerns Questionnaire were invited for in-person diagnostic evaluations. We found 9 children who had a confirmed diagnosis of autism spectrum disorder from the sample of 699. Receiver operating characteristic analyses determined that a two-domain cutoff score yielded optimal classification of children: 31% of those meeting algorithm cutoffs had autism spectrum disorder and 85% had a developmental disability or concern by age 3. These results suggest that the First Year Inventory is a promising tool for identifying 12-month-old infants who are at risk for an eventual diagnosis of autism spectrum disorder.
    Autism 09/2013; 17(5):527-540. DOI:10.1177/1362361312439633 · 3.50 Impact Factor
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