Early behavioral profiles elucidating vulnerability and resiliency to later ASD outcomes

Landa, Rebecca; Reetzke, Rachel; Tahseen, Madiha; Hess, Christine Reiner

doi:10.1017/s0954579420000814

Cited by 3 publications

(6 citation statements)

References 82 publications

(123 reference statements)

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“…Membership in the Lost Diagnosis group was predicted at Time 1 only by a low level of IJA. Greater expressive language skills (likely reflecting better representational and communication skills) and lower levels of RRB (possibly reflecting greater attentional and cognitive flexibility) may function as resiliency factors ( 47 ). By Time 2, predictors of membership in the Lost Diagnosis group expanded to include all three variables, which is not surprising given that 74% of the children in this group were diagnosed with ASD at Time 2.…”

Section: Discussionmentioning

confidence: 99%

“…Since joint attention limitations are often observed in young children with ASD ( 45 ) and joint attention skills strongly predict early language development ( 46 ) as well as later pragmatic communication skills ( 41 ), we examined Time 1 and Time 2 initiation of joint attention (IJA) behavior as predictors of Time 3 diagnostic classification. An IJA composite variable was derived using the sum of ADOS ratings from three items: Initiation of Joint Attention, Showing , and Giving ( 47 ). To account for differences across the ADOS Toddler Module and Module 1 in the range of item ratings and the operational definitions of those ratings, recoding of items was necessary to align item ratings across modules.…”

Section: Methodsmentioning

confidence: 99%

“…Descriptive data were analyzed for four school-age outcome groups (Stable ASD, Lost Diagnosis, Later Diagnosed, and Stable non-ASD) to describe demographic characteristics (see Table 1 ). Given previous findings suggesting potential female resilience in ASD ( 47 , 52 ), Fisher's exact tests were used to examine whether sex distributions significantly differed by diagnostic group.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic Stability and Phenotypic Differences Among School-Age Children Diagnosed With ASD Before Age 2

et al. 2022

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Given the importance of early detection, it is critical to understand the non-linearity in manifestation of ASD before age 24 months, when ASD symptoms are beginning to consolidate, through the age of 36 months when stability of ASD diagnosis is reportedly high into school-age when increased demands may challenge previously successful compensatory processes and permit first ASD detection. We employed a prospective, longitudinal design focused on children with an older sibling with ASD (n = 210) who received diagnostic evaluations at mean ages of 15.4 months (Time 1), 36.6 months (Time 2), and 5.7 years (Time 3) to examine: (1) diagnostic stability, (2) developmental trajectories associated with different patterns of ASD vs. non-ASD classifications, and (3) predictors of classification group over time. Clinical best estimate (CBE) diagnosis of ASD or non-ASD was made at each time point. Linear mixed-effects models were implemented to examine differences in developmental trajectories of stable and dynamic diagnostic groups. Multinomial logistic regression analyses were used to examine predictors of the likelihood of belonging to each CBE diagnostic classification group. Results revealed that sensitivity and stability of an ASD diagnosis significantly increased from Time 1 (sensitivity: 52%; stability: 63%) to Time 2 (sensitivity: 86%; stability: 68%). Different developmental trajectories of autism symptom severity and non-verbal and verbal IQ were observed across groups, with differences first observed at Time 1 and becoming more pronounced through Time 3. Presence of restricted and repetitive behaviors as well as limitations in initiation of joint attention and expressive language skills differentially predicted the likelihood of belonging to the different CBE diagnostic classification groups. Results suggest that ASD symptoms may emerge or attenuate over time, with some children meeting diagnosis at follow-up, and other children no longer meeting diagnostic criteria. From a systems perspective, diagnostic non-linearity may be viewed as a dynamic developmental process, where emergent properties arising from various biological, genetic, and experiential factors interact, culminating in phenotypic phenomena that change over time. Clinical implications include extending universal ASD and social communication screening into school-age, supporting families' understanding of diagnostic shifts, and ensuring unbiased diagnostic decision-making when following children with ASD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Diagnostic Stability and Phenotypic Differences Among School-Age Children Diagnosed With ASD Before Age 2

et al. 2022

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“…Consistent with previous literature (Landa et al, 2012), ASD diagnosis at 36 months of age correlated with class membership, with the 55.6% of ASD children being represented in overall developmental slowing class. More interestingly, a recent study showed that children with an accelerated development in motor, cognitive, and language development from 6 to 36 months of age are "resilient" to the development of ASD (Landa et al, 2020).…”

Section: The Predictive Role Of Language Trajectories On Asd Symptomsmentioning

confidence: 99%

“…Although a direct assessment of language and produced gestures development may have been a valid alternative, parental reports are particularly suitable to be used with toddlers in the early stages of language acquisition (Sachse & Von Suchodoletz, 2008). In addition, behavioral studies should be conducted to assess the developmental status of gestures (Landa et al, 2020).…”

Section: The Predictive Role Of Language Trajectories On Asd Symptomsmentioning

confidence: 99%

Early developmental trajectories of expressive vocabulary and gesture production in a longitudinal cohort of Italian infants at high‐risk for Autism Spectrum Disorder

et al. 2021

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Delays in language are a hallmark feature of Autism Spectrum Disorder (ASD). However, little is known about the predictive role of language developmental trajectories on ASD. The present study aimed at identifying early different language developmental profiles of infants at high familial risk for ASD (HR-ASD) and testing their predictive role on ASD symptoms at 2 years. The role of gestures on socio-communicative skills has also been explored. Trajectories of expressive vocabulary were investigated in 137 HR-ASD infants at 12, 18, and, 24 months of age. Parents were requested to complete the Italian version of the MacArthur-Bates Communicative Development Inventory and ASD symptoms were measured by ADOS-2. Latent class growth analysis defined four trajectories: above average language development group (above-average LD, 18.2%), normal language development group (NLD, 38.7%), late-onset language development group (late-onset LD, 11.7%), and a group of children with stable language delay (SLD, 31.4%). Results showed that the SLD group obtained higher communicative difficulties and restricted/repetitive behavior compared to the other groups. Examining early increase of produced gestures in the different language classes, we found fewer produced gestures between 12 and 18 months in the SLD group compared to the late-onset LD group. The results identified clusters of HR infants who follow similar estimated trajectories based on individual differences in language development. These patterns of early language acquisition, together with produced gestures, may be predictive of later ASD symptoms and useful for planning prompt intervention.Lay Summary: Language/gesture deficits are hallmark features of Autism Spectrum Disorder (ASD), but the predictive role of communicative trajectories on ASD remains unclear. In a longitudinal Italian sample of infants at high familial risk for ASD (HR-ASD), we tested if language trajectories and their link with gestures can predict ASD symptoms. We found four trajectories and HR infants with a stable language delay (SLD) trajectory showed more ASD symptoms later on. SLD infants produced fewer gestures compared to late-onset language development group that show more typical communicative skills.

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Reciprocal Associations Between Language Ability and Social Functioning Development in Pre-verbal Autistic Children

Oosting

Howard

Carter

2023

J Autism Dev Disord

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Early behavioral profiles elucidating vulnerability and resiliency to later ASD outcomes

Cited by 3 publications

References 82 publications

Diagnostic Stability and Phenotypic Differences Among School-Age Children Diagnosed With ASD Before Age 2

Diagnostic Stability and Phenotypic Differences Among School-Age Children Diagnosed With ASD Before Age 2

Early developmental trajectories of expressive vocabulary and gesture production in a longitudinal cohort of Italian infants at high‐risk for Autism Spectrum Disorder

Reciprocal Associations Between Language Ability and Social Functioning Development in Pre-verbal Autistic Children

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