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.
    Full-text · Article · Aug 2014 · Journal of Abnormal Child Psychology
    • "Performance on the SSI may not vary based on age because the SSI measures the child's capacity to engage in social interactions, and not the quality of these attempts, which may vary with age. This is consistent with research by Landa et al. (2007) that examined the social, communication, and play behaviors of children who were 14-to 36-months old and at high or low risk for Autism Spectrum Disorders which found that gains in social interaction abilities in children with ASDs were especially meager, even in comparison to the minimal gains in play and communication in toddlers with ASDs (Landa et al., 2007). "
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    ABSTRACT: Deficits in the capacity to engage in social interactions are a core deficit associated with Autistic Disorder (AD) and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). These deficits emerge at a young age, making screening for social interaction deficits and interventions targeted at improving capacity in this area important for early identification and intervention. Screening and early intervention efforts are particularly important given the poor short and long term outcomes for children with Autism Spectrum Disorders (ASDs) who experience social interaction deficits. The Screen for Social Interaction (SSI) is a well-validated screening measure that examines a child's capacity for social interaction using a developmental approach. The present study identified four underlying factors measured by the SSI, namely, Connection with Caregiver, Interaction/Imagination, Social Approach/Interest, and Agreeable Nature. The resulting factors were utilized to compare social interaction profiles across groups of children with AD, PDD-NOS, children with non-ASD developmental and/or psychiatric conditions and typically developing children. The results indicate that children with AD and those with PDD-NOS had similar social interaction profiles, but were able to be distinguished from typically developing children on every factor and were able to be distinguished from children with non-ASD psychiatric conditions on every factor except the Connection with Caregiver factor. In addition, children with non-ASD developmental and/or psychiatric conditions could be distinguished from typically developing children on the Connection with Caregiver factor and the Social Approach/Interest factor. These findings have implications for screening and intervention for children with ASDs and non-ASD psychiatric conditions.
    No preview · Article · Jun 2014 · Research in Developmental Disabilities
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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/).
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