Response to distress in infants at risk for autism: a prospective longitudinal study
Ted Hutman1, Agata Rozga, Angeline D DeLaurentis
1UCLA Center for Autism Research & Treatment, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095-1759, USA. thutman@mednet.ucla.edu
Insights
Infants later diagnosed with Autism Spectrum Disorder (ASD) showed reduced attention and emotional response to distress from 12 months. Early distress response deficits predict later ASD diagnosis, highlighting potential for early intervention.
Area of Science:
- Developmental Psychology
- Clinical Psychology
- Neuroscience
Background:
- Infants and preschoolers with Autism Spectrum Disorder (ASD) exhibit impaired responses to others' distress compared to typically developing children.
- This deficit can disrupt social interaction, learning, and relationship formation.
- Previous research had not evaluated distress response in infants with ASD before 18 months of age.
Purpose of the Study:
- To evaluate distress response in infants at high risk for ASD.
- To determine if distress response differences are present in early infancy.
- To assess the predictive value of distress response for later ASD diagnosis.
Main Methods:
- 103 infant siblings of children with autism and 55 low-risk controls participated.
- Infants' responsiveness to a simulated distress event was recorded at 12, 18, 24, and 36 months.
- Attention and affect changes were coded using Likert scales.
Main Results:
- Infants later diagnosed with ASD showed less attention and affect change to distress compared to controls.
- These group differences persisted even when controlling for verbal skills and general social responsiveness.
- Distress response differences were evident from 12 months of age.
Conclusions:
- Diagnostic groups show differing distress responses between 12 and 36 months.
- Distress response measures predict later ASD diagnosis independently of verbal abilities.
- Early distress response is a promising target for intervention in infants at risk for ASD.
Background:
Infants and preschoolers with ASD show impairment in their responses to other people's distress relative to children with other developmental delays and typically developing children. This deficit is expected to disrupt social interactions, social learning, and the formation of close relationships. Response to distress has not been evaluated previously in infants with ASD earlier than 18 months of age.
Methods:
Participants were 103 infant siblings of children with autism and 55 low-risk controls. All children were screened for ASD at 36 months and 14 were diagnosed with ASD. Infants' responsiveness to distress was evaluated at 12, 18, 24, and 36 months. An examiner pretended to hit her finger with a toy mallet and infants' responses were video-recorded. Attention to the examiner and congruent changes in affect were coded on four-point Likert scales.
Results:
Cross-sectional and longitudinal analyses confirm that the ASD group paid less attention and demonstrated less change in affect in response to the examiner's distress relative to the high-risk and low-risk participants who were not subsequently diagnosed with ASD. Group differences remained when verbal skills and general social responsiveness were included in the analytic models.
Conclusions:
Diagnostic groups differ on distress response from 12 to 36 months of age. Distress-response measures are predictive of later ASD diagnosis above and beyond verbal impairments. Distress response is a worthwhile target for early intervention programs.
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