Response to Name in Infants Developing Autism Spectrum Disorder: A Prospective Study

Area of Science:

• Developmental Pediatrics
• Neurodevelopmental Disorders
• Early Childhood Development

Background:

• Early detection of autism spectrum disorder (ASD) is critical for timely intervention and improved outcomes.
• Response to name is a key early social communication milestone that can be affected in infants at high risk for ASD.
• Longitudinal tracking of developmental trajectories in high-risk infants informs diagnostic and prognostic understanding.

Purpose of the Study:

• To investigate longitudinal patterns of response to name in infants at high and low risk for autism spectrum disorder (ASD) from 6 to 24 months of age.
• To assess the predictive value of name response for identifying ASD and later developmental outcomes.
• To compare the developmental trajectories of infants who develop ASD based on the frequency of name response failures.

Main Methods:

• A cohort of 156 infants, including high-risk (siblings of children with ASD) and low-risk (siblings of typically developing children), were assessed for response to name at 6, 9, 12, 15, 18, and 24 months.
• Participants were classified at 36 months into three outcome groups: ASD, high-risk without ASD, and low-risk without ASD.
• Generalized estimating equations were used to analyze longitudinal performance differences, and sensitivity/specificity for ASD identification were calculated.

Main Results:

• Infants who later developed ASD were significantly more likely to fail to orient to their names starting at 9 months, a pattern persisting through 24 months.
• The sensitivity and specificity for identifying ASD based on at least one failure to respond to name between 12 and 24 months were estimated at 0.70.
• Infants with ASD who exhibited repeated failures to respond to name showed poorer 36-month receptive language skills and earlier ASD diagnosis compared to those with infrequent failures.

Conclusions:

• Regular monitoring of response to name is recommended for infants at risk for ASD, alongside standard screening protocols.
• Consistent failure to respond to one's name during the second year of life may indicate not only a risk for ASD but also for more significant developmental impairments by age 3.
• Response to name serves as a valuable early behavioral marker for identifying infants at risk for autism spectrum disorder and predicting later developmental trajectories.