WHAT'S KNOWN ON THIS SUBJECT:The sibling recurrence risk of autism has been estimated to be between 3% and 10%. Previous research was affected by small samples and selection, stoppage, and reporting limitations. Updated estimates of recurrence risk are needed. WHAT THIS STUDY ADDS:Studying a large sample and using a prospective longitudinal design, this study demonstrated that the sibling recurrence risk of autism spectrum disorder is substantially higher than previous estimates. This elevated risk has important implications for infant screening and genetic counseling. abstract OBJECTIVE: The recurrence risk of autism spectrum disorders (ASD) is estimated to be between 3% and 10%, but previous research was limited by small sample sizes and biases related to ascertainment, reporting, and stoppage factors. This study used prospective methods to obtain an updated estimate of sibling recurrence risk for ASD. METHODS:A prospective longitudinal study of infants at risk for ASD was conducted by a multisite international network, the Baby Siblings Research Consortium. Infants (n ϭ 664) with an older biological sibling with ASD were followed from early in life to 36 months, when they were classified as having or not having ASD. An ASD classification required surpassing the cutoff of the Autism Diagnostic Observation Schedule and receiving a clinical diagnosis from an expert clinician. RESULTS:A total of 18.7% of the infants developed ASD. Infant gender and the presence of Ͼ1 older affected sibling were significant predictors of ASD outcome, and there was an almost threefold increase in risk for male subjects and an additional twofold increase in risk if there was Ͼ1 older affected sibling. The age of the infant at study enrollment, the gender and functioning level of the infant's older sibling, and other demographic factors did not predict ASD outcome. CONCLUSIONS:The sibling recurrence rate of ASD is higher than suggested by previous estimates. The size of the current sample and prospective nature of data collection minimized many limitations of previous studies of sibling recurrence. Clinical implications, including genetic counseling, are discussed. Pediatrics 2011;128:e488-e495 AUTHORS:

In development, children often use gesture to communicate before they use words. The question is whether these gestures merely precede language development or are fundamentally tied to it. We examined 10 children making the transition from single words to two-word combinations and found that gesture had a tight relation to the children's lexical and syntactic development. First, a great many of the lexical items that each child produced initially in gesture later moved to that child's verbal lexicon. Second, children who were first to produce gesture-plus-word combinations conveying two elements in a proposition (point at bird and say "nap") were also first to produce two-word combinations ("bird nap"). Changes in gesture thus not only predate but also predict changes in language, suggesting that early gesture may be paving the way for future developments in language.

During the first eighteen months of life, infants acquire and refine a whole set of new motor skills that significantly change the ways in which the body moves in and interacts with the environment. In this review article, I argue that motor acquisitions provide infants with an opportunity to practice skills relevant to language acquisition before they are needed for that purpose; and that the emergence of new motor skills changes infants' experience with objects and people in ways that are relevant for both general communicative development and the acquisition of language. Implications of this perspective for current views of co-occurring language and motor impairments and for methodology in the field of child language research are also considered.

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This study explores the communicative use of the gestural and vocal modalities by normally developing Italian children during the transition from one- to two-word speech. We analysed the spontaneous production of 12 children at 1;4 and at 1;8, focusing on the use of two-element combinations of words and/or gestures. Results indicated that use of gesture and gesture-word combinations during the transition to two-word speech is a robust feature of communicative development across a relatively large number of children in a rich gestural culture, and that the number of gesture-word and two-word combinations increased significantly from 1;4 to 1;8. Number of gestures and gesture-word combinations produced at 1;4 was also predictive of total vocal production at 1;8. Findings are discussed in terms of the role of gesture as a transitional device en route to two-word speech.