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Predictive value of subclinical autistic traits at age 14-15 months for behavioural and cognitive problems at age 3-5
Esmé Möricke1, Sophie H N Swinkels, Karin T Beuker
1Department of Psychiatry (966), Nijmegen Centre for Evidence-Based Practice (NCEBP), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Insights
Early signs of autistic traits in infants can predict later behavioral and language issues, not necessarily autism spectrum disorder. These early indicators highlight the importance of monitoring developmental trajectories.
Area of Science:
- Developmental Psychology
- Child Psychiatry
- Behavioral Science
Background:
- Subclinical autistic traits in early childhood require further investigation regarding their persistence and clinical significance.
- Understanding the long-term impact of early subclinical autistic traits is crucial for timely interventions.
Purpose of the Study:
- To examine the relationship between subclinical autistic traits in infants and later developmental, behavioral, cognitive, and language outcomes.
- To determine if early subclinical autistic traits predict later autism spectrum disorder diagnoses or other developmental challenges.
Main Methods:
- Infants (14-15 months) from the general population completed the Early Screening of Autistic Traits Questionnaire (ESAT).
- Children were grouped by ESAT scores (high, moderate, low) and followed up with assessments at ages 3 and 4-5 years.
- Follow-up assessments included the Child Behavior Checklist (CBCL), Social Communication Questionnaire (SCQ), Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule-Generic (ADOS-G), non-verbal intelligence tests, and language tests.
Main Results:
- Children with high ESAT scores at 14-15 months exhibited significantly more internalizing and externalizing problems at age 3.
- High ESAT scorers also showed significantly lower language comprehension and production skills at age 4-5 years.
- A higher proportion of children with high ESAT scores fell into high-risk ranges for behavioral, cognitive, and language problems, though none were diagnosed with autism spectrum disorder.
Conclusions:
- Subclinical autistic traits identified in infancy are predictive of later behavioral problems and delays in cognitive and language functioning.
- These early traits do not appear to predict later autism spectrum disorder diagnoses but indicate a need for monitoring for other developmental issues.
- Early identification of subclinical autistic traits can aid in recognizing children at risk for behavioral, language, and cognitive challenges, informing early intervention strategies.
Abstract:
It is unclear whether subclinical autistic traits at very young age are transient or stable, and have clinical relevance. This study investigated the relationship between early subclinical autistic traits and the occurrence of later developmental and behavioural problems as well as problems in cognitive and language functioning. Parents of infants aged 14-15 months from the general population completed the Early Screening of Autistic Traits Questionnaire (ESAT). Three groups of children with high, moderate, and low ESAT-scores (total n = 103) were selected. Follow-up assessments included the CBCL 1(1/2)-5 at age 3 years, and the SCQ, the ADI-R, the ADOS-G, an on-verbal intelligence test, and language tests for comprehension and production at age 4-5 years. None of the children met criteria for autism spectrum disorder at follow-up. Children with high ESAT-scores at 14-15 months showed significantly more internalizing and externalizing problems at age 3 years and scored significantly lower on language tests at age 4-5 years than children with moderate or low ESAT-scores. Further, significantly more children with high ESAT-scores (14/26, 53.8%) than with moderate and low ESAT-scores (5/36, 13.9% and 1/41, 2.4%, respectively) were in the high-risk/clinical range on one or more outcome domains (autistic symptoms, behavioural problems, cognitive and language abilities). Subclinical autistic traits at 14-15 months predict later behavioural problems and delays in cognitive and language functioning rather than later ASD-diagnoses. The theoretical implications of the findings lie in the pivotal role of early social and communication skills for the development of self-regulation of emotions and impulses. The practical implications bear on the early recognition of children at risk for behavioural problems and for language and cognitive problems.
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