Clinical assessment of autism in high-risk 18-month-olds
Abstract
Earlier intervention improves outcomes for children with autism spectrum disorders (ASDs), but existing identification tools are at the limits of standardization with 18-month-olds. We assessed potential behavioural markers of ASD at 18 months in a high-risk cohort of infant siblings of children with ASD. Prospective data were collected using the Autism Diagnostic Observation Schedule (ADOS) and Autism Observation Scale for Infants (AOSI) on 155 infant siblings and 73 low-risk controls at 18 months. Infants were classified into three groups (ASD sibs, non-ASD sibs, controls) based on blind best-estimate diagnosis at age 3. Fisher's exact tests, followed by discriminant function analyses, revealed that the majority of informative ADOS items came from the social and behavioural domains, and AOSI items measuring behavioural reactivity and motor control contributed additional information. Findings highlight the importance of considering not only social-communication deficits, but also basic dimensions of temperament including state regulation and motor control when assessing toddlers with suspected ASD.
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For most high-risk (HR) infants, the hallmark features of ASD, social-communication deficits, and repetitive behavior are not evident until 12 months of age or later.
“It appears that for most high-risk (HR) infants, the hallmark features of ASD, social-communication deficits, and repetitive behavior are not evident until 12 months of age or later [3, 10, 12, 14, 36, 47, 49].”
From Behavioral, cognitive, and adaptive development in infants with autism spectrum disorder in the first 2 years of life (2015) · cites this paper as [3]
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- Authors
- Brian, J., Bryson, S. E., Garon, N., Roberts, W., Smith, I. M., Szatmari, P., & Zwaigenbaum, L.
- Affiliations
- University of Toronto (CA)
- Izaak Walton Killam Health Centre (CA)
- Hospital for Sick Children (CA)
- McMaster University, Hamilton, Canada
- University of Alberta (CA)
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2008-09
- Volume
- 12
- Issue
- 5
- Pages
- 433-456
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- OpenAlex
- W2142104347
- Cited by
- 234
- References
- 52
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 8 · 2021: 9 · 2020: 44 · 2019: 12 · 2018: 10 · 2017: 20 · 2016: 15 · 2015: 18 · 2014: 10 · 2013: 17 · 2012: 14
- FWCI
- 6.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Autism Speaks
- Bloorview Research Institute
- Dalhousie University
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Keywords
- autism spectrum disorder, infant siblings, high-risk infants, early detection, behavioural markers, autism screening, Autism Diagnostic Observation Schedule, temperament, government regulation, motor control, social communication deficits, toddlers
- MeSH terms
- Autistic Disorder, Female, Humans, Infant, Male, Risk Factors, Severity of Illness Index, Discriminant Analysis
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