A video‐based measure to identify autism risk in infancy

Abstract

Background Signs of autism are present in the first 2 years of life, but the average age of diagnosis lags far behind. Instruments that improve detection of autism risk in infancy are needed. This study developed and tested the psychometric properties of a novel video‐based approach to detecting ASD in infancy. Methods A prospective longitudinal study of children at elevated or lower risk for autism spectrum disorder was conducted. Participants were 76 infants with an older sibling with ASD and 37 infants with no known family history of autism. The Video‐referenced Infant Rating System for Autism (VIRSA) is a web‐based application that presents pairs of videos of parents and infants playing together and requires forced‐choice judgments of which video is most similar to the child being rated. Parents rated participants on the VIRSA at 6, 9, 12, and 18 months of age. We examined split‐half and test–retest reliability; convergent and discriminant validity; and sensitivity, specificity, and negative and positive predictive value for concurrent and 36‐month ASD diagnoses. Results The VIRSA demonstrated satisfactory reliability and convergent and discriminant validity. VIRSA ratings were significantly lower for children ultimately diagnosed with ASD than children with typical development by 12 months of age. VIRSA scores at 18 months identified all children diagnosed with ASD at that age, as well as 78% of children diagnosed at 36 months. Conclusions This study represents an initial step in the development of a novel video‐based approach to detection of ASD in infancy. The VIRSA's psychometric properties were promising when used by parents with an older affected child, but still must be tested in community samples with no family history of ASD. If results are replicated, then the VIRSA's low‐burden, web‐based format has the potential to reduce disparities in communities with limited access to screening.

Information and Communication Technologies to Support Early Screening of Autism Spectrum Disorder: A Systematic Review

“…Ages of the children involved in the studies varied greatly. Two studies involved children from 6 to 18 months [ 42 , 43 ]. Six studies involved children within the 10 to 48 months range [ 36 , 40 , 41 , 44 , 45 , 46 ], seven studies involved participants aged between 16 and 30 months [ 22 , 25 , 31 , 32 , 34 , 35 , 47 ], and four studies involved children within the 18- and 72-months range [ 37 , 39 , 48 , 49 ].…”

“…In a similar vein, the studies reported by Egger et al [ 25 ] and Carpenter et al [ 36 ] were included both in the NUI and PC/Mobile category. Accordingly, 11 papers reported on the use of computerized solutions (PC or mobile platforms) to administer parent-reported questionnaires [ 22 , 31 , 32 , 33 , 34 , 35 , 37 , 39 , 46 , 47 , 55 ], and seven papers employed screening tools in which videos were collected from [ 37 , 39 , 43 , 50 ] or showed via [ 25 , 36 , 42 ] parents’ mobile/PC devices.…”

“…Two papers were included that involved children up to 18 months [ 42 , 43 ]. Young et al [ 42 ] developed a web-based application named Video-referenced Infant Rating System for Autism (VIRSA). The application is intended to be used by parents and shows pairs of videos of parents and infants playing together.…”

“…In these studies, home-made videos could be further supplemented by short questionnaires to improve the accuracy of the screening process. Alternatively, Young et al [ 42 ] substituted text-based with video-based questionnaires to enable detection of ASD in infancy and clearly showed that video can be used to improve parent reporting of early development. Together, mobile-based solutions may be considered a strategy to (a) reduce the burden on health services, (b) increase the number of screened children, and (c) accelerate the diagnostic process.…”

Identification of amygdala-expressed genes associated with autism spectrum disorder

“…The timing of expression of ASD susceptibility genes during fetal development is in line with the early detection of core symptoms in individuals with ASD. Although the age at which ASD behavioral traits emerge varies, many of the signs, such as gaze aversion, are detectable by as early as 12 months [16,17]. That early brain developmental deficits underlie ASD is further supported by postmortem studies of ASD brains which reveal cortical deficits explainable by alterations in prenatal development [18].…”