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Published on: April 22, 2015
Initiating joint attention use in infants at high-risk for autism spectrum disorder
A M Brewe1, D L Reisinger1, S M Adlof2
1Department of Psychology, University of South Carolina, Columbia, SC, USA.
Insights
Early joint attention behaviors in infants at high risk for autism spectrum disorder (ASD) were examined. While infants with fragile X syndrome showed some differences, 12-month-old behaviors were not distinct enough to predict later ASD diagnosis.
Area of Science:
- Developmental Psychology
- Neurodevelopmental Disorders
- Pediatric Medicine
Background:
- Impaired initiating joint attention (IJA) is linked to autism spectrum disorder (ASD) in children.
- Studying high-risk infants (those with an older sibling with ASD or fragile X syndrome) offers insight into early IJA behaviors.
- Understanding IJA development is crucial due to its early emergence and the later diagnosis of ASD.
Purpose of the Study:
- To investigate differences in IJA use among infants at high risk for ASD compared to typically developing peers at 12 months of age.
- To determine if early IJA behaviors at 12 months are associated with later ASD outcomes.
- To explore the relationship between IJA and nonverbal cognitive development in high-risk infants.
Main Methods:
- An experimental attention task was employed to analyze IJA gaze shifts and gestures in high-risk infants and typically developing controls.
- Participants were assessed at 12 months for IJA behaviors.
- Clinical best estimate diagnoses were used to correlate IJA behaviors with ASD severity and outcomes at 24 months.
Main Results:
- No significant differences in the frequency of IJA gaze shifts and gestures were observed between infants with an older sibling with ASD (ASIBs) and typically developing (TD) controls at 12 months.
- Infants with fragile X syndrome (FXS) exhibited a significantly reduced range of IJA gaze shifts compared to TD controls.
- IJA use at 12 months was associated with ASD outcomes at 24 months for infants with FXS, but not for ASIBs, with these associations explained by nonverbal cognitive development.
Conclusions:
- IJA behaviors in high-risk infants (ASIBs and FXS) at 12 months were not markedly distinct from TD children, contrary to some previous findings at later ages.
- Observed differences in IJA at 12 months were primarily attributed to nonverbal cognitive development, especially in infants with FXS.
- The subtle differences in IJA use at 12 months in this study were insufficient to serve as a reliable early indicator for later ASD diagnosis.
Background:
Impairment in initiating joint attention (IJA) is associated with autism spectrum disorder (ASD) in children, although it is unclear when impairments arise. Due to the early development of IJA use and late diagnosis of ASD, groups at high-risk of ASD, such as infants with an older sibling with ASD (ASIBs) and infants with fragile X syndrome (FXS), provide opportunities to study early IJA behaviours for children who are later diagnosed with ASD. This study analysed these two groups to determine if IJA use differed compared with typically developing (TD) peers at 12 months and whether IJA was associated with later ASD outcomes.
Method:
An experimental attention task was used to analyse IJA gaze shifts and gestures in the high-risk groups. Clinical best estimate diagnoses were given to each participant to compare IJA behaviours to ASD severity.
Results:
No differences in the frequency of IJA gaze shifts and gestures were found between 12-month-old ASIBs and TD controls, but infants with FXS demonstrated a significantly reduced range of IJA gaze shifts relative to TD controls. Additionally, ASD outcomes at 24 months were related to IJA use for infants with FXS at 12 months, but not infant ASIBs, although these findings were explained by differences in nonverbal cognitive development.
Conclusions:
Although previous studies have reported delays in IJA use in children with FXS and ASIBs at ages 21 and 14 months, respectively, our results suggest IJA behaviours for these high-risk groups are not distinct from TD children at 12 months. When differences were found at 12 months, they were explained by nonverbal cognitive development, particularly for infants with FXS. Differences in IJA use at 12 months in this study were too small to serve as a potential indicator of later ASD.
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