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Published on: September 20, 2024
Repetitive behavior in 12-month-olds later classified with autism spectrum disorder
Jed T Elison1, Jason J Wolff2, J Steven Reznick3
1Institute of Child Development at the University of Minnesota, Minneapolis.
Insights
Early repetitive behaviors in infants may help identify autism spectrum disorder (ASD). Infants at high risk for ASD showed more stereotyped movements and object manipulation than low-risk infants, suggesting targeted assessment can aid early ASD detection.
Area of Science:
- Developmental Psychology
- Pediatric Neurology
- Autism Spectrum Disorder Research
Background:
- Early social communication markers are established predictors for autism spectrum disorder (ASD).
- Less is understood regarding the predictive value of early restricted and repetitive behaviors (RRBs) for later ASD diagnosis.
- Infant RRBs, including stereotyped motor mannerisms and object manipulation, are key areas for investigation.
Purpose of the Study:
- To investigate patterns of stereotyped motor mannerisms and repetitive object manipulation in 12-month-old infants at high and low risk for ASD.
- To determine the association between these early behaviors and a confirmed ASD diagnosis at 24 months.
- To explore the utility of assessing RRBs for augmenting early ASD identification.
Main Methods:
- Observational coding of repetitive behaviors using the Repetitive and Stereotyped Movement Scales (RSMS).
- Analysis of digital recordings from the Communication and Symbolic Behavior Scales in three infant groups: low-risk (LR), high-familial-risk negative for ASD (HR-negative), and high-familial-risk with ASD (HR-ASD).
- Assessment of ASD diagnosis at 24 months for all participants.
Main Results:
- The HR-ASD group exhibited significantly more stereotyped motor mannerisms compared to both HR-negative and LR groups.
- Both HR-ASD and HR-negative groups showed significantly higher repetitive object manipulation scores than the LR group.
- A composite RSMS score revealed a disorder-continuum effect, with significant differences between all three groups (LR < HR-negative < HR-ASD).
Conclusions:
- Early-emerging stereotyped motor mannerisms and repetitive object manipulation are associated with later ASD diagnosis.
- Targeted assessment of repetitive behaviors in infancy shows promise for enhancing early identification of ASD.
- These findings highlight the importance of considering RRBs alongside social communication markers in infant ASD screening.
Objective:
As compared to the utility of early emerging social communicative risk markers for predicting a later diagnosis of autism spectrum disorder (ASD), less is known about the relevance of early patterns of restricted and repetitive behaviors. We examined patterns of stereotyped motor mannerisms and repetitive manipulation of objects in 12-month-olds at high and low risk for developing ASD, all of whom were assessed for ASD at 24 months.
Method:
Observational coding of repetitive object manipulation and stereotyped motor behaviors in digital recordings of the Communication and Symbolic Behavior Scales was conducted using the Repetitive and Stereotyped Movement Scales for 3 groups of 12-month-olds: low-risk infants (LR, n = 53); high-familial-risk infants who did not meet diagnostic criteria for ASD at 24 months (HR-negative, n = 75); and high-familial-risk infants who met diagnostic criteria for ASD at 24 months (HR-ASD, n = 30).
Results:
The HR-ASD group showed significantly more stereotyped motor mannerisms than both the HR-negative group (p = .025) and the LR group (p = .001). The HR-ASD and HR-negative groups demonstrated statistically equivalent repetitive object manipulation scores (p = .431), and both groups showed significantly more repetitive object manipulation than the LR group (p < .040). Combining the motor and object stereotypy scores into a Repetitive and Stereotyped Movement Scales (RSMS) composite yielded a disorder-continuum effect such that each group was significantly different from one another (LR < HR-negative < HR-ASD).
Conclusion:
These results suggest that targeted assessment of repetitive behavior during infancy may augment early ASD identification efforts.
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