Purpose Infant siblings of children with autism spectrum disorder (ASIBs) and infants with fragile X syndrome (FXS) are both at risk for developing autism spectrum disorder (ASD) and communication disorders; however, very few studies have examined 1 of the earliest forms of intentional communication in infants from these groups: gestures. This study examined the frequency and function of gesture use across 12-month-old infant ASIBs, infants with FXS, and low-risk controls. Method Participants included 23 ASIBs who did not later meet diagnostic criteria for ASD, 18 infants with FXS, and 21 low-risk controls. Gestures were coded from a semistructured play-based interaction. Results Overall, infants with FXS displayed fewer gestures than low-risk infants, whereas ASIBs did not differ from the FXS or low-risk groups in overall gesture frequency. In terms of the communicative function of the gestures used, the FXS and ASIB groups displayed significantly fewer social interaction gestures than the low-risk controls, with large effect sizes. Conclusion This study contributes to scant knowledge of early communication phenotypes of infant ASIBs who do not meet criteria for ASD and infants with FXS. Results indicated that gesture function, not frequency, best discriminated at-risk infants from low-risk infants at 12 months of age. Findings have implications for the clinical evaluation and treatment of infants at high risk for ASD and communication disorders.

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Children with autism spectrum disorder (ASD) receive a variety of treatments, which vary in terms of empirical support (evidence-based vs. negligible), delivery setting (school-based vs. private), and target (biochemical processes vs. behavior/learning). Although some treatments are more commonly used (i.e., speech-language therapy, occupational therapy), widely accepted (i.e., Applied Behavior Analysis [ABA]), and/or well-researched (i.e., early intensive behavioral intervention) compared with others, innumerable treatment options are available that purport to address core or related symptoms of ASD. Complex and multiple factors including child symptoms, parent perceptions and choices, and availability of or access to care influence treatments ultimately sought for children with ASD, but very little is known about whether and how use of treatment types varies in different U.S. regions. Understanding such patterns may provide insight into ASD-affected families' treatment preferences and needs in various geographic locations, and this was the purpose of the current study.

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