Observed Social Emotional Behavior at 22 Months Predicts a Later ASD Diagnosis in High-Risk Siblings.

Social engagement, pretend play, and concern for another's distress represent fundamental features of typical social-emotional development in the second year. Children with autism spectrum disorder (ASD) display delays and deficits in these areas, and research on toddlers at heightened risk for ASD (HR; younger siblings of children with ASD) indicates these deficits may be apparent in toddlerhood. Prior research has examined these aspects of social-emotional development individually in HR toddlers. The present paper examines them jointly as predictors of ASD. We show that social engagement, pretend play, and empathic concern at 22-months each contribute uniquely to predicting later ASD diagnosis with high specificity and moderate sensitivity. Results have important implications for early diagnosis and intervention in young children with ASD.

Trajectories of Posture Development in Infants With and Without Familial Risk for Autism Spectrum Disorder.

This study investigated early posture development prospectively in infants at heightened (HR) vs. low risk (Low Risk; LR) for ASD. Fourteen HR infants diagnosed with ASD (HR-ASD), 17 HR infants with language delay (HR-LD), 29 HR infants with no diagnosis (HR-ND), and 25 LR infants were videotaped at home for 25 min during everyday activities and play at 6, 8, 10, 12, and 14 months. All postures were coded and the sustainment source was identified for supported postures. Relative to LR infants, HR-ASD infants and to a lesser extent HR-LD infants exhibited distinct postural trajectories that revealed slower development of more advanced postures. In addition, subtle differences in posture sustainment differentiated HR-ASD from HR-LD infants.

The Relation Between Walking and Language in Infant Siblings of Children With Autism Spectrum Disorder.

In typical development, walk onset is accompanied by increased language growth (e.g., Walle & Campos, 2014). The present study explored whether this relation may be disrupted in the infant siblings of children with autism spectrum disorder (ASD; heightened risk of receiving an ASD diagnosis; HR), a population exhibiting substantial variability in motor and language development (e.g., Gamliel, Yirmiya, & Sigman, 2007; Landa & Garrett-Mayer, 2006). Receptive and expressive language were examined across the transition to walking in three groups of HR infants (no diagnosis, language delay, and ASD; N = 91, 8-18 months) and in infants with no family history of ASD (N = 25; 9-15 months). Only infants with an eventual ASD diagnosis did not show increased language growth following walk onset.

Coordination is key: Joint attention and vocalisation in infant siblings of children with Autism Spectrum Disorder.

BACKGROUND: Research indicates that social communicative behaviours develop atypically during the second year in Autism Spectrum Disorder (ASD). This study evaluated whether these behaviours also differed in the extent to which they were coordinated across modalities. AIMS: To measure joint attention behaviours (e.g., gaze shifts, gestures), vocalisations and their coordination among a cohort of infants with an older sibling with ASD (heightened risk-HR). METHODS & PROCEDURES: This prospective longitudinal study examined 50 HR infants at 14, 18 and 24 months. The Early Social Communication Scales (ESCS)-a structured toy-play task that assesses infant joint attention behaviour-was administered to infants at each age point in the home. Infants' joint attention behaviours, vocalisations and instances where they overlapped were coded from videos. At 36 months, nine infants received an ASD diagnosis (HR-ASD), 15 had a significant language delay (HR-LD) and 26 were classified no diagnosis (HR-ND). OUTCOMES & RESULTS: Findings revealed that HR-ASD infants produced fewer advanced joint attention behaviours, and their vocalisations were less frequent and less advanced than HR-LD and HR-ND infants. Notably, HR-ASD infants also coordinated these behaviours together less frequently than their HR peers. CONCLUSIONS & IMPLICATIONS: Differences in the coordination of early communicative behaviours may have negative cascading effects on social and language development for infants who develop ASD. Current intervention practices may be complemented by efforts to increase the coordinated quality of communicative behaviours.

Early Gesture and Vocabulary Development in Infant Siblings of Children with Autism Spectrum Disorder.

This study examined longitudinal growth in gestures and words in infants at heightened (HR) versus low risk (LR) for ASD. The MacArthur-Bates Communicative Development Inventory was administered monthly from 8 to 14 months and at 18 and 24 months to caregivers of 14 HR infants diagnosed with ASD (HR-ASD), 27 HR infants with language delay (HR-LD), 51 HR infants with no diagnosis (HR-ND), and 28 LR infants. Few differences were obtained between LR and HR-ND infants, but HR-LD and HR-ASD groups differed in initial skill levels and growth patterns. While HR-LD infants grew at rates comparable to LR and HR-ND infants, growth was attenuated in the HR-ASD group, with trajectories progressively diverging from all other groups.

Developmental Changes in Pretend Play from 22- to 34-Months in Younger Siblings of Children with Autism Spectrum Disorder.

Developmental trajectories of children's pretend play and social engagement, as well as parent sensitivity and stimulation, were examined in toddlers with an older sibling with autism spectrum disorder (ASD, high risk; HR) and toddlers with typically-developing older siblings (low risk; LR). Children (N = 168, 97 boys, 71 girls) were observed at 22, 28, and 34 months during free play with a parent and elicited pretend play with an examiner. At 28 and 34 months, children were asked to imagine the consequences of actions pantomimed by the examiner on a pretend transformation task. At 36 months children were assessed for ASD, yielding 3 groups for comparison: HR children with ASD, HR children without ASD (HR-noASD), and LR children. Children in all 3 groups showed developmental changes, engaging in more bouts of pretend play and obtaining higher scores on the elicited pretend and transformation tasks with age, but children with ASD lagged behind the other 2 groups on most measures. Children with ASD were also less engaged with their parents or the examiner during play interactions than either LR or HR-noASD children, with minimal developmental change evident. Parents, regardless of group, were highly engaged with their children, but parents of HR-noASD children received somewhat higher ratings on stimulation than parents of LR children. Most group differences were not accounted for by cognitive functioning. Instead, lower social engagement appears to be an important correlate of less advanced pretend skills, with implications for understanding the early development of children with ASD and for early intervention.

The development of autism spectrum disorders: variability and causal complexity.

The autism spectrum is highly variable, both behaviorally and neurodevelopmentally. Broadly speaking, four related factors contribute to this variability: (1) genetic processes, (2) environmental events, (3) gene × environment interactions, and (4) developmental factors. Given the complexity of the relevant processes, it appears unlikely that autism spectrum atypicalities can be attributed to any one causal mechanism. Rather, the development of neural atypicality reflects an interaction of genetic and environmental risk factors. As the individual grows, changes in neural atypicality, consequent variation in behavior, and environmental response to that behavior may become linked in a positive feedback loop that amplifies deviations from the typical developmental pattern. WIREs Cogn Sci 2017, 8:e1426. doi: 10.1002/wcs.1426 For further resources related to this article, please visit the WIREs website.

Pretend Play and Social Engagement in Toddlers at High and Low Genetic Risk for Autism Spectrum Disorder.

Toddlers with an older sibling with autism spectrum disorder (ASD) and low risk (LR) toddlers with typically-developing older siblings were observed during free play with a parent and elicited pretend with an examiner at 22-months. Functional and pretend play, children's social engagement, and parent sensitivity were assessed during free play. Complexity of play was assessed during the elicited pretend task. Toddlers with an ASD diagnosis showed less pretend play across contexts and less social engagement with parents or the examiner than either LR toddlers or high risk toddlers without a diagnosis (HR-noASD). Lower levels of pretend play and social engagement were associated with symptom severity within the high risk group, reflecting emerging ASD in toddlerhood.

Concern for Another's Distress in Toddlers at High and Low Genetic Risk for Autism Spectrum Disorder.

We examined concern for others in 22-month-old toddlers with an older sibling with autism spectrum disorder (ASD) and low risk typically-developing toddlers with older siblings. Responses to a crying infant and an adult social partner who pretended to hurt her finger were coded. Children with a later diagnosis of ASD showed limited empathic concern in either context compared to low risk toddlers. High risk toddlers without a later diagnosis fell between the ASD and low risk groups. During the crying baby probe the low risk and high risk toddlers without a diagnosis engaged their parent more often than the toddlers with ASD. Low levels of empathic concern and engagement with parents may signal emerging ASD in toddlerhood.

Social engagement with parents in 11-month-old siblings at high and low genetic risk for autism spectrum disorder.

Infant siblings of children with an autism spectrum disorder are at heightened genetic risk to develop autism spectrum disorder. We observed high risk (n = 35) and low risk (n = 27) infants at 11 months during free play with a parent. Children were assessed for autism spectrum disorder in toddlerhood. High-risk infants with a later diagnosis (n = 10) were less socially engaged with their parents than were low-risk infants. Parent behavior during play did not vary by group. Within the high-risk group, ratings of social reciprocity at 11 months predicted Autism Diagnostic Observation Schedule severity scores at follow-up, suggesting that systematic observations of parent-infant play may be a useful addition to early assessments of emerging autism spectrum disorder.

Maternal verbal responses to communication of infants at low and heightened risk of autism.

This study investigates mothers' responses to infant communication among infants at heightened genetic risk (high risk) of autism spectrum disorder compared to infants with no such risk (low risk). A total of 26 infants, 12 of whom had an older sibling with autism spectrum disorder, were observed during naturalistic in-home interaction and semistructured play with their mothers at 13 and 18 months of age. Results indicate that overall, mothers of low-risk and high-risk infants were highly and similarly responsive to their infants' communicative behaviors. However, examination of infant vocal and gestural communication development together with maternal verbal responses and translations (i.e. verbally labeling a gesture referent) suggests that delays in early communication development observed among high-risk infants may alter the input that these infants receive; this in turn may have cascading effects on the subsequent development of communication and language.

Object exploration at 6 and 9 months in infants with and without risk for autism.

During the first year of life, infants spend substantial amounts of time exploring objects they encounter in their daily environments. Perceptuo-motor information gained through these experiences provides a foundation for later developmental advances in cognition and language. This study aims to examine developmental trajectories of visual, oral, and manual object exploration in infants with and without risk for autism spectrum disorder before the age of 1 year. A total of 31 infants, 15 of whom had an older sibling with autism and who were therefore at heightened risk for autism spectrum disorder, played with sounding and nonsounding rattles at 6 and 9 months of age. The results suggest that heightened-risk infants lag behind their low-risk peers in the exploration of objects. The findings are discussed in terms of how delays in object exploration in infancy may have cascading effects in other domains.