Article

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: 13.75). 08/2007; 64(7):853-64. DOI: 10.1001/archpsyc.64.7.853
Source: PubMed

ABSTRACT 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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    • "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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    • "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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    • "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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