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Early Developmental Trends in High-Risk Neonates Later Diagnosed With Autism Spectrum Disorder
Helen Carey1, Kelly Tanner, Karen Ratliff-Schaub
1College of Health Sciences (Dr Carey), University of Indianapolis, Indianapolis, Indiana; Division of Clinical Therapies (Dr Tanner), Nationwide Children's Hospital, Columbus, Ohio; College of Medicine (Dr Ratliff-Schaub), University of South Carolina, Greenville, South Carolina; Phoenix Children's Hospital (Ms Baldino), Phoenix, Arizona; Center for Advanced Technology and Robotic Rehab (Dr Kelly), Children's Healthcare of Atlanta, Atlanta, Georgia; College of Public Health (Dr Andridge), The Ohio State University, Columbus, Ohio.
Insights
Early developmental assessments in high-risk infants can identify autism spectrum disorder (ASD). A significant decline in Bayley-III scores over time indicated potential early signs of ASD in affected infants.
Area of Science:
- Neonatal development
- Autism Spectrum Disorder (ASD) research
- Developmental pediatrics
Background:
- Infants born prematurely or with neonatal morbidity are at increased risk for ASD.
- Early identification of ASD is crucial for timely intervention and improved outcomes.
- Limited research exists on using standard developmental tools for early ASD detection in high-risk neonates.
Purpose of the Study:
- To determine if clinical data from a neonatal intensive care unit (NICU) follow-up clinic can identify early manifestations of ASD.
- To evaluate the utility of developmental assessments in identifying early signs of ASD in high-risk infants.
Main Methods:
- Retrospective chart review of 144 infants (72 with ASD, 72 matched controls) from a NICU developmental follow-up clinic.
- Data collected from the Test of Infant Motor Performance (TIMP) and Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months.
- Analysis of developmental scores and change over time between infants diagnosed with ASD and controls.
Main Results:
- No significant differences were found in TIMP scores between groups.
- Bayley-III scaled scores differed significantly between ASD and control groups at two time points.
- The ASD group showed a significantly greater decline in cognitive and communication Bayley-III scores over time.
Conclusions:
- High-risk neonates later diagnosed with ASD exhibited significant differences in developmental trajectories, notably a steeper decline in Bayley-III scores.
- Early, longitudinal developmental surveillance is critical for identifying ASD risk in neonates.
- This study underscores the importance of utilizing developmental surveillance instruments for early ASD detection in at-risk infant populations.
Purpose:
We hypothesized that clinical data from a neonatal intensive care unit (NICU) infant developmental follow-up clinic would identify early manifestations of autism spectrum disorder (ASD).
Methods:
One hundred forty-four infants were identified; 72 later diagnosed with ASD and 72 controls. Retrospective chart review provided data from the Test of Infant Motor Performance (TIMP) and the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months of age.
Results:
Between-group comparisons indicated no significant group difference in TIMP scores; however, Bayley-III scaled scores differed between the groups at 2 administration times. The within-group Bayley-III change scores declined significantly more for the ASD group in cognitive and communication subtests.
Conclusion:
High-risk neonates, due to prematurity or morbidity, later diagnosed with ASD demonstrated statistically significant differences, including a more precipitous drop in Bayley-III scores over time. Early, longitudinal developmental surveillance for neonates at risk of ASD is critical. What this adds to the evidence: Early identification of ASD is critical to optimize developmental outcomes in young children, including infants born prematurely or with neonatal morbidity, who are perceived to have an increased risk for ASD. Despite these findings, minimal research has been conducted to evaluate the utility of commonly administered norm-referenced developmental surveillance instruments to identify possible early signs of ASD in this high-risk population due to prematurity or neonatal morbidity and not familial association. The present study analyzed retrospectively collected clinical data from a NICU developmental follow-up clinic for 144 infants, 72 of which were later diagnosed with ASD and 72 sex- and gestational age-matched controls. Results demonstrated statistically significant poorer Bayley-III outcomes for the ASD group compared with controls at 2 different study time points, including a more precipitous drop in Bayley-III scaled scores over time. This study highlights the importance of early and longitudinal developmental surveillance for high-risk neonates at risk of ASD.
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