A prospective study of response to name in infants at risk for autism
Aparna S Nadig1, Sally Ozonoff, Gregory S Young
1University of California Davis M.I.N.D. Institute, Sacramento, CA 95817, USA. aparna.nadig@ucdmc.ucdavis.edu
Insights
A decreased response to name by 12 months suggests developmental issues, but doesn't identify all cases of autism spectrum disorder (ASD) or developmental delays. This early indicator may reflect traits of the broader autism phenotype in infants.
Area of Science:
- Developmental Pediatrics
- Neurodevelopmental Disorders
- Early Childhood Development
Background:
- Early identification of developmental delays and autism spectrum disorders (ASD) is crucial for timely intervention.
- Assessing infant responses to their names is a potential, non-invasive screening method.
- Understanding the predictive value of early behavioral markers is essential for improving diagnostic accuracy.
Purpose of the Study:
- To evaluate the sensitivity and specificity of a diminished response to one's name at 12 months of age as a screening tool for autism spectrum disorders (ASD) and other developmental delays.
- To determine the predictive accuracy of failing to respond to name in infancy for later developmental outcomes.
Main Methods:
- A prospective, longitudinal study design was employed, following infants at high risk for ASD and a control group.
- Participants included 6- and 12-month-old infants at risk for ASD and age-matched controls.
- Infants underwent an experimental task to elicit response-to-name behavior, with follow-up assessments using the Autism Diagnostic Observation Schedule and Mullen Scales of Early Learning.
Main Results:
- At 12 months, 100% of control infants responded to name within two calls, compared to 86% of infants at risk for ASD.
- Children who failed the response-to-name task at 12 months had a high likelihood (75%) of identified developmental problems by 24 months.
- The specificity of failing to respond to name was high (0.89 for ASD, 0.94 for any delay), but sensitivity was moderate (0.50 for ASD, 0.39 for any delay).
Conclusions:
- A lack of response to name by 12 months strongly suggests potential developmental abnormalities but is not a universal predictor for all children at risk.
- Not all infants who are later diagnosed with ASD or developmental delays fail to respond to their name.
- Poor response to name in infancy may represent a characteristic of the broader autism phenotype.
Objective:
To assess the sensitivity and specificity of decreased response to name at age 12 months as a screen for autism spectrum disorders (ASD) and other developmental delays.
Design:
Prospective, longitudinal design studying infants at risk for ASD.
Setting:
Research laboratory at university medical center.
Participants:
Infants at risk for autism (55 six-month-olds, 101 twelve-month-olds) and a control group at no known risk (43 six-month-olds, 46 twelve-month-olds). To date, 46 at-risk infants and 25 control infants have been followed up to 24 months. Intervention Experimental task eliciting response-to-name behavior.
Main Outcome Measures:
Autism Diagnostic Observation Schedule, Mullen Scales of Early Learning.
Results:
At age 6 months, there was a nonsignificant trend for control infants to require a fewer number of calls to respond to name than infants at risk for autism. At age 12 months, 100% of infants in the control group "passed," responding on the first or second name call, while 86% in the at-risk group did. Three fourths of children who failed the task were identified with developmental problems at age 24 months. Specificity of failing to respond to name was 0.89 for ASD and 0.94 for any developmental delay. Sensitivity was 0.50 for ASD and 0.39 for any developmental delay.
Conclusions:
Failure to respond to name by age 12 months is highly suggestive of developmental abnormality but does not identify all children at risk for developmental problems. Lack of responding to name is not universal among infants later diagnosed with ASD and/or other developmental delays. Poor response to name may be a trait of the broader autism phenotype in infancy.
