Behavioral, cognitive, and adaptive development in infants with autism spectrum disorder in the first 2 years of life
Annette Estes1,2, Lonnie Zwaigenbaum3, Hongbin Gu4,5
1Department of Speech and Hearing Sciences, University of Washington, Seattle, WA USA.
Insights
Early signs of autism spectrum disorder (ASD) appear as atypical sensorimotor development at 6 months in high-risk infants. These differences predict later cognitive and behavioral challenges by 24 months.
Area of Science:
- Developmental neuroscience
- Pediatric neurology
- Autism research
Background:
- Autism spectrum disorder (ASD) diagnosis relies on behavioral symptoms, often identified later in childhood.
- Understanding early developmental trajectories in infants at high risk for ASD is crucial for early intervention.
Purpose of the Study:
- To investigate the early developmental characteristics of infants with high familial risk (HR) for ASD compared to low-risk (LR) infants.
- To delineate the progression of ASD symptoms from 6 to 24 months of age.
Main Methods:
- Longitudinal study of 210 HR and 98 LR infants assessed at 6, 12, and 24 months.
- Evaluated cognitive development, adaptive skills, and early behavioral features of ASD.
- Stratified participants into four groups based on ASD diagnosis and symptom severity: HR-ASD-High, HR-ASD-Moderate, HR-Neg, and LR-Neg.
Main Results:
- Significant developmental differences emerged between groups from 6 to 24 months across all assessed domains.
- At 6 months, HR-ASD-High infants showed delays in Gross Motor and Visual Reception skills.
- By 24 months, both HR-ASD-High and HR-ASD-Moderate groups exhibited significant differences in cognitive, adaptive, and behavioral domains compared to controls.
Conclusions:
- Atypical sensorimotor development at 6 months is associated with later ASD diagnosis in the most severely affected infants.
- Sensorimotor deficits precede cognitive/adaptive deficits and autism features between 6 and 24 months.
- Less severely affected infants show later symptom onset, with initial social-communication differences.
Background:
To delineate the early progression of autism spectrum disorder (ASD) symptoms, this study investigated developmental characteristics of infants at high familial risk for ASD (HR), and infants at low risk (LR).
Methods:
Participants included 210 HR and 98 LR infants across 4 sites with comparable behavioral data at age 6, 12, and 24 months assessed in the domains of cognitive development (Mullen Scales of Early Learning), adaptive skills (Vineland Adaptive Behavioral Scales), and early behavioral features of ASD (Autism Observation Scale for Infants). Participants evaluated according to the DSM-IV-TR criteria at 24 months and categorized as ASD-positive or ASD-negative were further stratified by empirically derived cutoff scores using the Autism Diagnostic Observation Schedule yielding four groups: HR-ASD-High, HR-ASD-Moderate (HR-ASD-Mod), HR-ASD-Negative (HR-Neg), and LR-ASD-Negative (LR-Neg).
Results:
The four groups demonstrated different developmental trajectories that became increasingly distinct from 6 to 24 months across all domains. At 6 months, the HR-ASD-High group demonstrated less advanced Gross Motor and Visual Reception skills compared with the LR-Neg group. By 12 months, the HR-ASD-High group demonstrated increased behavioral features of ASD and decreased cognitive and adaptive functioning compared to the HR-Neg and LR-Neg groups. By 24 months, both the HR-ASD-High and HR-ASD-Moderate groups demonstrated differences from the LR- and HR-Neg groups in all domains.
Conclusions:
These findings reveal atypical sensorimotor development at 6 months of age which is associated with ASD at 24 months in the most severely affected group of infants. Sensorimotor differences precede the unfolding of cognitive and adaptive deficits and behavioral features of autism across the 6- to 24-month interval. The less severely affected group demonstrates later symptom onset, in the second year of life, with initial differences in the social-communication domain.
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