Does a claims diagnosis of autism mean a true case?

The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis code (n = 182), (b) one claim with an autism spectrum disorder diagnosis code (n = 190), and (c) those who had no claims for autism spectrum disorder but had claims for other developmental or neurological conditions (n = 60). The algorithm-based diagnoses were compared with documented autism spectrum disorders in the medical charts. The algorithm requiring more than or equal to two claims for autism spectrum disorder generated a positive predictive value of 87.4%, which suggests that such an algorithm is a valid means to identify true autism spectrum disorder cases in claims data.

Anticipatory smiling: linking early affective communication and social outcome.

In anticipatory smiles, infants appear to communicate pre-existing positive affect by smiling at an object and then turning the smile toward an adult. We report two studies in which the precursors, development, and consequences of anticipatory smiling were investigated. Study 1 revealed a positive correlation between infant smiling at 6 months and the level of anticipatory smiling at 8 and 10 months during joint attention episodes, as well as a positive correlation between anticipatory smiling and parent-rated social expressivity scores at 30 months. Study 2 confirmed a developmental increase in the number of infants using anticipatory smiles between 9 and 12 months that had been initially documented in the Study 1 sample [Venezia, M., Messinger, D. S., Thorp, D., & Mundy, P. (2004). The development of anticipatory smiling. Infancy, 6(3), 397-406]. Additionally, anticipatory smiling at 9 months positively predicted parent-rated social competence scores at 30 months. Findings are discussed with regard to the importance of anticipatory smiling in early socioemotional development.

Tracking childhood exposure to lead and developmental disabilities: examining the relationship in a population-based sample.

Elevated levels of lead detected in the blood are associated with harmful effects on children's learning and behavior. The goal of the current Environmental Public Health Tracking Project was to examine the relationship between selected developmental disabilities and childhood blood lead levels in a population-based sample. Using extant datasets from the Florida Department of Health, Childhood Lead Poisoning Prevention Program, and the Florida Department of Education, we were able to isolate a linked dataset of children who were tested for lead poisoning and attended public schools. Special education categories served as a proxy for developmental disabilities; the prevalence of these disabilities in the sample of children with blood lead levels was compared with that in children who attended the same schools but were not tested for lead poisoning. Results indicated that children screened for lead poisoning were more likely to be receiving services for behavior problems, mental retardation, learning disabilities, or a speech-language impairment than other children attending the same schools. Implications for using administrative datasets to examine this relationship are discussed.

Driven from distraction: how infants respond to parents' attempts to elicit and re-direct their attention.

This experiment examined how parents' verbal and non-verbal behavioral cues cause infants to shift and share attention within environments where many objects compete for infants' attention. Fifteen- and 21-month-old infants played with toys while their parent periodically shifted attention to a distal object within a larger array. Parents' attention-shifts were indicated by a change in direction of gaze, a pointing gesture, and/or verbalizations. Verbalizations were either attention-eliciting or attention-directing. In some trials parents covered their eyes to occlude line-of-gaze. Both ages seldom followed simple gaze shifts, but frequently followed gaze with-points or gaze-with-directing verbalizations. Attention-eliciting verbalizations increased infants' looks to the parent. Gaze occlusion reduced infants' responses to directing verbalizations. Responses to eliciting verbalizations increased with age. Infant receptive vocabulary did not predict attention-sharing, even when parents named objects (i.e., directing verbalizations). Implications for development of attention-sharing, language and understanding of visual attention are discussed.