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Caregiver-reported infant motor and imitation skills predict M-CHAT-R/F
Samantha Levick1,2, Angela D Staples1, Seth Warschausky2
1Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA.
Insights
Caregiver reports of infant imitation at 4, 6, and 9 months can help identify early signs of Autism Spectrum Disorder (ASD). This new measure, combined with motor skills assessment, predicts ASD risk by 18 months, aiding earlier detection.
Area of Science:
- Developmental Psychology
- Pediatrics
- Neuroscience
Background:
- Altered infant motor and social-communicative abilities are early indicators for Autism Spectrum Disorder (ASD).
- Current ASD diagnostic tools are often not usable until 12 months, leading to delayed diagnosis.
- Infant imitation, a key skill combining motor and social-communicative functions, is frequently atypical in infants at risk for ASD.
Purpose of the Study:
- To develop and validate a caregiver-report measure for assessing infant imitation at 4, 6, and 9 months.
- To explore the relationship between caregiver-reported imitation, motor abilities, and later ASD risk.
- To address the diagnostic age gap in ASD through accessible early screening.
Main Methods:
- A large, multi-site study involving 571 caregivers of term and preterm infants using the PediaTrac™ web-based developmental monitoring tool.
- Caregivers completed online surveys and established questionnaires from birth to 18 months, including the M-CHAT-R/F at 18 months.
- Factor analysis was used to derive imitation factors from PediaTrac data at 4, 6, and 9 months, with validity assessed through associations with communication measures (CSBS, ASQ).
Main Results:
- Distinct imitation factors were identified at 4, 6, and 9 months, showing valid associations with infant communication measures.
- Infant imitation and motor skills reported at 9 months significantly predicted ASD risk at 18 months.
- These predictive factors remained significant even after accounting for gestational age.
Conclusions:
- A caregiver-report measure of infant imitation can be reliably developed and validated for early detection of ASD risk.
- Assessing infant imitation and motor skills in the first year of life can aid in identifying infants at higher risk for ASD.
- This approach has implications for improving early ASD detection, potentially reducing the diagnostic age gap and increasing access to timely interventions.
Abstract:
Altered motor and social-communicative abilities in infancy have been linked to later ASD diagnosis. Most diagnostic instruments for ASD cannot be utilized until 12 months, and the average child is diagnosed substantially later. Imitation combines motor and social-communicative skills and is commonly atypical in infants at risk for ASD. However, few measures have been developed to assess infant imitation clinically. One barrier to the diagnostic age gap of ASD is accessibility of screening and diagnostic services. Utilization of caregiver report to reliably screen for ASD mitigates such barriers and could aid in earlier detection. The present study developed and validated a caregiver-report measure of infant imitation at 4, 6, and 9 months and explored the relationship between caregiver-reported imitation and motor abilities with later ASD risk. Participants (N = 571) were caregivers of term and preterm infants recruited as part of a large multi-site study of PediaTrac™, a web-based tool for monitoring and tracking infant development. Caregivers completed online surveys and established questionnaires on a schedule corresponding to well-child visits from birth to 18 months, including the M-CHAT-R/F at 18 months. Distinct imitation factors were derived from PediaTrac at 4, 6, and 9 months via factor analysis. The results supported validity of the imitation factors via associations with measures of infant communication (CSBS; ASQ). Imitation and motor skills at 9 months predicted 18-month ASD risk over and above gestational age. Implications for assessment of infant imitation, detecting ASD risk in the first year, and contributing to access to care are discussed.
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