A Prospective Study of the Emergence of Early Behavioral Signs of Autism

MIND Institute, University of California-Davis, Sacramento, California 95817, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 03/2010; 49(3):256-66.e1-2. DOI: 10.1097/00004583-201003000-00009
Source: PubMed


To examine prospectively the emergence of behavioral signs of autism in the first years of life in infants at low and high risk for autism.
A prospective longitudinal design was used to compare 25 infants later diagnosed with an autism spectrum disorder (ASD) with 25 gender-matched low-risk children later determined to have typical development. Participants were evaluated at 6, 12, 18, 24, and 36 months of age. Frequencies of gaze to faces, social smiles, and directed vocalizations were coded from video and rated by examiners.
The frequency of gaze to faces, shared smiles, and vocalizations to others were highly comparable between groups at 6 months of age, but significantly declining trajectories over time were apparent in the group later diagnosed with ASD. Group differences were significant by 12 months of age on most variables. Although repeated evaluation documented loss of skills in most infants with ASD, most parents did not report a regression in their child's development.
These results suggest that behavioral signs of autism are not present at birth, as once suggested by Kanner, but emerge over time through a process of diminishment of key social communication behaviors. More children may present with a regressive course than previously thought, but parent report methods do not capture this phenomenon well. Implications for onset classification systems and clinical screening are also discussed.

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    • "First, changes in parent smiling were associated with changes in child smiling, which was not directly targeted in our intervention, thus supporting our premise that changes in parent behavior may result in changes in child behavior, even if not targeted directly. The potential to increase positive affect in our participants is encouraging in light of evidence of declining positive affect sharing in high-risk infants with ASD between 12 and 24 months of age[Ozonoff et al., 2010;Landa et al., 2013], reduced smiling in high-risk infants with ASD more generally[Filliter et al., 2015], and the important role positive affect plays in learning. Further, a moderate association emerged between gains in parent smiling and increased child orienting to the parent. "
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    ABSTRACT: The Social ABCs is a parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD). We undertook a multi-site pilot study to evaluate feasibility and acceptability, and to identify trends in child and parent behavior to inform future research using a larger sample and a rigorous research design. The program involved 12 weeks of parent coaching, followed by 12 weeks' implementation, and 3-month follow-up assessment for 20 parent-toddler dyads (age range: 12-32 months). Parents successfully learned the techniques and rated the intervention as highly acceptable. Paired samples t-tests revealed significant gains in children's functional communication (responsivity, initiations), and language gains (age-equivalents on standardized measures) commensurate with typical developmental rates. Significant increases in shared smiling and social orienting also emerged, but were attenuated at follow-up. Parents' fidelity was positively associated with child responsivity. Training parents as mediators is a feasible and highly acceptable approach that provides a potentially cost-effective opportunity for intensive intervention at a very young age at the first signs of ASD risk. Child and parent gains in several key variables demonstrate the promise of this intervention. Autism Res 2015. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
    Preview · Article · Dec 2015 · Autism Research
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    • "Only a handful live eye-tracking studies have been published so far involving children with ASD (Falck-Ytter, Carlström, & Johansson, 2015; Hanley, et al., 2014; Nadig, Lee, Singh, Bosshart, & Ozonoff, 2010; Noris, Nadel, Barker, Hadjikhani, & Billard, 2012). One reason why so few studies of this type have been conducted may be that eye-tracking experiments involving live person-to-person interaction can be more methodologically challenging and time consuming than conventional (screenbased ) eye tracking (Gredebäck, Fikke, & Melinder, 2010; Risko, Laidlaw, Freeth, Foulsham, & Kingstone, 2012). "
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    ABSTRACT: Autism Spectrum Disorder (ASD) is characterized by socio-communicative impairments, and limited attention to other people's faces is thought to be an important underlying mechanism. Here, non-invasive eye-tracking technology was used to quantify the amount of time spent looking at another person's face during face-to-face communication in children with ASD (n = 13, age 6 years) and age and IQ-matched neurotypical children (n = 27, 6 years). We found that in one context of high ecological relevance – listening to an adult telling a children's story – children with ASD showed a markedly reduced tendency to look at the adult's face. In interactions between typical children and the adult, the amount of gaze to the other's face aligned between the two individuals. No such relation was found when the ASD group interacted with the adult. Despite these differences in the storytelling context, we also observed that social looking atypicalities did not generalize to another and more structured context, implying that social looking cannot not be considered fundamentally disrupted in children with ASD.
    Full-text · Article · Sep 2015 · Research in Autism Spectrum Disorders
    • ". This group of infants are at heightened risk of developing ASD themselves , and so can be followed prospectively to identify early markers of later diagnosis . Several recent such studies have revealed that infants with later ASD show remarkably typical patterns of looking at social stimuli in early infancy ( e . g . , Elsabbagh et al . , 2013 ; Ozonoff et al . , 2010"
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    ABSTRACT: Between 6 and 12 months, typically developing infants undergo a socio-cognitive "revolution." The Interactive Specialization (IS) theory of brain development predicts that these behavioral changes will be underpinned by developmental increases in the power and topographic extent of socially selective cortical responses. To test this hypothesis, we used EEG to examine developmental changes in cortical selectivity for ecologically valid dynamic social versus non-social stimuli in a large cohort of 6- and 12-month-old infants. Consistent with the Interactive Specialization model, results showed that differences in EEG Θ activity between social and non-social stimuli became more pronounced and widespread with age. Differences in EEG activity were most clearly elicited by a live naturalistic interaction, suggesting that measuring brain activity in ecologically valid contexts is central to mapping social brain development in infancy. © 2015 Wiley Periodicals, Inc. Dev Psychobiol. © 2015 Wiley Periodicals, Inc.
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