How Early Do Parent Concerns Predict Later Autism Diagnosis?

M.I.N.D. Institute, University of California Davis Health System, Sacramento, CA 95817, USA.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.13). 10/2009; 30(5):367-75. DOI: 10.1097/DBP.0b013e3181ba0fcf
Source: PubMed


To study the relationship between parent concerns about development in the first year and a half of life and later autism diagnostic outcomes.
Parent concerns about development were collected for infants at high and low risk for autism, using a prospective, longitudinal design. Parents were asked about developmental concerns at study intake and when their infant was 6, 12, and 18 months. Infants were then followed up until 36 months, when diagnostic status was determined.
By the time their child was 12 months, parents who have an older child with autism reported significantly more concerns in autism spectrum disorders-related areas than parents of children with typical outcomes. These concerns were significantly related to independent measures of developmental status and autism symptoms and helped predict which infants would later be diagnosed with autism or autism spectrum disorders. At 6 months, however, the concerns of parents who have an older child with autism do not predict outcome well.
Explicitly probing for parent concerns about development is useful for identifying children in need of closer monitoring and surveillance, as recommended by the American Academy of Pediatrics.

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    • "Moreover, our operationalization of children's social motivation was broad (i.e., preference to be in the company of others) and based on parents' perspective. Even though parent reports of children's behavior are generally reliable (e.g., Dirks and Boyle 2010), meaningful (Verhulst et al. 1994) and diagnostically relevant (Ozonoff et al. 2009), it may be difficult for parents to report on the internal motives of their child. Future studies on the role of children's social motivation in self-presentation or reputation management should therefore ideally include both broad and narrow operationalizations of social motivation and different informants (parent and child) or methods (experiment and questionnaires). "
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    ABSTRACT: We compared self-presentation abilities of 132 children and adolescents with autism spectrum disorders (ASD) to those of 41 typically developing (TD) peers, and examined the potential link with their social motivation and perspective taking. Participants introduced themselves to an interviewer in a baseline condition (without incentive) and a self-promotion condition (with incentive). Children with ASD (6-12 years) were just as likely as or even more likely than TD children to highlight personal characteristics that would increase their chances of obtaining the incentive. Thus, they were strategic in their self-presentation. However, adolescents with ASD (12-19 years) were less strategic than TD adolescents as well as children with ASD. We discuss the role of social motivation and perspective taking in children's self-presentation.
    Full-text · Article · Sep 2015 · Journal of Autism and Developmental Disorders
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    • "ger - Flusberg , 2010 ; Ruser et al . , 2007 ) . The elevated levels of concern consistently reported by mothers of high risk infants across the first year of life may also be associated with reduced linguistic input to the extent that those con - cerns reflect increased anxiety and a less sensitive pat - tern of responding ( Hess & Landa , 2012 ; Ozonoff et al . , 2009 ; Sacrey et al . , 2015 ; Talbott , Nelson , & Tager - Flusberg , 2015a ) . Alternatively , elevated concerns driven by maternal hypervigilance may be associated with increased attention , prompting , and reinforcing of infants ' early communication . Increases in these facili - tative maternal behaviors may also be supported by high ri"
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    ABSTRACT: Infant siblings of children with autism spectrum disorder display differences in early language and social communication skills beginning as early as the first year of life. While environmental influences on early language development are well documented in other infant populations, they have received relatively little attention inside of the infant sibling context. In this study, we analyzed home video diaries collected prospectively as part of a longitudinal study of infant siblings. Infant vowel and consonant-vowel vocalizations and maternal language-promoting and non-promoting verbal responses were scored for 30 infant siblings and 30 low risk control infants at 9 months of age. Analyses evaluated whether infant siblings or their mothers exhibited differences from low risk dyads in vocalization frequency or distribution, and whether mothers' responses were associated with other features of the high risk context. Analyses were conducted with respect to both initial risk group and preliminary outcome classification. Overall, we found no differences in infants' consonant-vowel vocalizations, the frequency of overall maternal utterances, or the distribution of mothers' response types. Both groups of infants produced more vowel than consonant-vowel vocalizations, and both groups of mothers responded to consonant-vowel vocalizations with more language-promoting than non-promoting responses. These results indicate that as a group, mothers of high risk infants provide equally high quality linguistic input to their infants in the first year of life and suggest that impoverished maternal linguistic input does not contribute to high risk infants' initial language difficulties. Implications for intervention strategies are also discussed. Autism Res 2015. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
    Full-text · Article · Jul 2015 · Autism Research
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    • "Sensitivity = TP/(TP + FN); Specificity = TN/(TN + FP); Positive predictive value = TP/(TP + FP); Negative predictive value = TN/(TN + FN). © 2015 Association for Child and Adolescent Mental Health. 2 Sally Ozonoff et al. & Landa, 2012; Ozonoff et al., 2009 "
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    ABSTRACT: Objective Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. While this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated specifically with ASD compared to other developmental outcomes. Method We applied Classification and Regression Trees (CART) analysis to individual items of the Autism Diagnostic Observation Schedule (ADOS) in 719 HR siblings to identify behavioral features at 18 months predictive of diagnostic outcomes (ASD, atypical development, and typical development) at 36 months. Results Three distinct combinations of features at 18 months were predictive of ASD outcome: 1) poor eye contact combined with lack of communicative gestures and giving; 2) poor eye contact combined with a lack of imaginative play; and 3) lack of giving and presence of repetitive behaviors, but with intact eye contact. These 18-month behavioral profiles predicted ASD versus non-ASD status at 36 months with 82.7% accuracy in an initial test sample and 77.3% accuracy in a validation sample. Clinical features at age 3 among children with ASD varied as a function of their 18-month symptom profiles. Children with ASD who were misclassified at 18 months were higher functioning, and their autism symptoms increased between 18 and 36 months. Conclusion These findings suggest the presence of different developmental pathways to ASD in HR siblings. Understanding such pathways will provide clearer targets for neural and genetic research and identification of developmentally specific treatments for ASD.
    Full-text · Article · Dec 2014 · Journal of the American Academy of Child & Adolescent Psychiatry
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