Onset Patterns in Autism: Correspondence Between Home Video and Parent Report

Abstract

Objective The onset of autism is usually conceptualized as occurring in one of two patterns, an early onset and a regressive pattern. This study examined the number and shape of trajectories of symptom onset evident in coded home movies of children with autism and examined their correspondence with parent report of onset. Methods Four social-communicative behaviors were coded from the home video of children with autism (n = 52) or typical development (n = 23). All home video from 6 through 24 months of age was coded (3199 segments). Latent class modeling was used to characterize trajectories and determine the optimal number needed to describe the coded home video. These trajectories were then compared to parent report of onset patterns, as defined by the Autism Diagnostic Interview-Revised. Results A three trajectory model best fit the data from the participants with autism. One trajectory displayed low levels of social-communication across time. A second trajectory displayed high levels of social-communication early in life, followed by a significant decline over time. A third trajectory displayed initial levels of behavior that were similar to the typically developing group, but little progress in social-communication with age. There was poor correspondence between home video-based trajectories and parent report of onset. Conclusions More than two onset categories may be needed to describe the ways in which symptoms emerge in children with autism. There is low agreement between parent report and home video, suggesting that methods for improving parent report of early development must be developed.

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

“…Recent papers have pointed out significant complexities in defining and measuring the onset of autism symptoms (18). Studies have demonstrated relatively low correspondence between parent report of onset and home videotape evidence of symptom trajectories (26), with one study showing that 45% of participants clearly demonstrated a regression on videotape that was not reported by parents (27). Similarly, a recent prospective study found that regression was evident in many infants who were developing autism but was reported by only a minority of parents (28).…”

18-Month Predictors of Later Outcomes in Younger Siblings of Children With Autism Spectrum Disorder: A Baby Siblings Research Consortium Study

“…Moreover, it is not clear when and how the behavioral symptoms begin to emerge. Symptoms may emerge after a period of relatively typical development either as a result of a loss of skills 16 or a failure to acquire new skills 17, 18 . The conceptualization of onset patterns is further complicated by the finding that some symptoms may show a gradual decrease in frequency (e.g., eye contact), whereas others fail to increase at the rate observed in typical controls 19 (e.g., social vocalizations), suggesting that the departure from typical trajectories in specific domains may follow different patterns and take place during different developmental periods.…”

Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research

“…8 Second, a proportion of children with ASD reportedly regress in the second year. Recent research has indicated only modest agreement between retroactively reported regression and analysis of behavioral change as observed on serial home videos 9 and that acute skill loss may exist along a continuum of gradually declining trajectories of social and communicative behavior. 10,11 However, interventions during this period may counter the developmental cascade that contributes to progressive symptom development and ultimately prevent ASD-related impairments before they fully manifest.…”