Early symptoms of autistic children and its diagnostic significance

Sensory Profiles in School-Aged Children with Autism Spectrum Disorder: A Descriptive Study Using the Sensory Processing Measure-2 (SPM-2)

Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF), IQ < 80). Results: ASD children exhibited higher scores throughout the SPM-2 total score and its multiple subscales. Within ASD, while HF and LF children did not differ in terms of the SPM-2 total score, a significant difference was found for the hearing, social participation, and balance and motion subscales. Conclusions: Aside from classical knowledge that the ASD population suffers from sensory processing disorders, we revealed that different sensory patterns are associated with high or low cognitive functioning. Beyond its neurobiological interest, such knowledge may be of fundamental importance for individualizing psychoeducational interventions in preschool- and school-aged children and later developmental stages.

Studying the emergence of autism spectrum disorders in high-risk infants: methodological and practical issues

Detecting early signs of autism is essential for timely diagnosis and initiation of effective interventions. Several research groups have initiated prospective studies of high-risk populations including infant siblings, to systematically collect data on early signs within a longitudinal design. Despite the potential advantages of prospective studies of young children at high-risk for autism, there are also significant methodological, ethical and practical challenges. This paper outlines several of these challenges, including those related to sampling (e.g., defining appropriate comparison groups), measurement and clinical implications (e.g., addressing the needs of infants suspected of having early signs). We suggest possible design and implementation strategies to address these various challenges, based on current research efforts in the field and previous studies involving high-risk populations.

A parent-report instrument for identifying one-year-olds at risk for an eventual diagnosis of autism: the first year inventory

A parent-report instrument, the First Year Inventory (FYI), was developed to assess behaviors in 12-month-old infants that suggest risk for an eventual diagnosis of autism. The target behaviors were identified from retrospective and prospective studies. FYIs were mailed to 5,941 families and 25% (N = 1,496) were returned, with higher return rates for white families and for families with greater educational attainment. Ad hoc groups of questions afforded measurement of eight specific constructs, which were combined to establish a general risk index. Boys had higher risk scores than did girls. Maternal race and education influenced answers. A small percentage of infants appeared to be at notably elevated risk. Large-scale longitudinal research is warranted to determine whether the FYI can predict an eventual diagnosis of autism.

On intersubjective engagement in autism: a controlled study of nonverbal aspects of conversation

Does autism involve a deficit in intersubjective engagement with other persons? We studied nonverbal communication in children and adolescents with and without autism (n = 12 per group), group-matched for chronological age and verbal mental age, during 3 min of a videotaped interview. In keeping with previous studies, there were only subtle but potentially revealing group differences on behavioral ratings. Participants with autism made fewer head-shakes/nods (but not smiles) when the interviewer was talking, and the interviewer made fewer head-shakes/nods when participants were talking. Yet there were marked group differences on reliable 'subjective' ratings of (a) affective engagement and (b) the smoothness of reciprocal interaction. We interpret the findings in terms of a group difference in identification between conversational partners.

Autism and developmental delay: a comparative clinical study in very young children using IBSE scale

OBJECTIVE

This study improves the knowledge of early autistic symptomatology and research concerning (i) the significant differences in the behaviors of children with autistic disorder (AD) and children with a developmental delay (DD), and (ii) the influence of the cognitive delay on symptomatology.

METHOD

Two groups of 20 young children (7-42 months) were compared: children with AD, and those with DD. The groups were paired by chronological and developmental age. The comparison was extended to four subgroups composed according to age (younger and older children--<24 months, >24 months) and to the global development quotient (GDQ) (the more and less delayed). Each child was evaluated with the Infant Behavior Summarized Evaluation scale (IBSE).

RESULTS

For the younger AD children, significant differences affected social communication and their adaptation to the environment (intolerance to frustration, resistance to change). For the older children (>24 months), this study showed the rapid progression of the number of distinctive signs between AD and DD children according to age and/or developmental level.

CONCLUSIONS

Cognitive delay has an important influence on the symptomatology at the moment of initial recognition of an autistic syndrome. This study is a complement for the fuller understanding of the nature and early diagnosis of disorders specific to autism at the earliest phases of development.

Early features of autism: Repetitive behaviours in young children

This study examined whether repetitive behaviours were a differentiating feature of autism in children aged less than 51 months. The study also examined the relationship between age (chronological and developmental) and repetitive behaviours in young children with autism. Standardised developmental and diagnostic assessments were conducted on 55 children aged between 22 and 51 months, consisting of 40 developmentally delayed children with DSM-IV-TR Autistic Disorder and 15 developmentally delayed children without Autistic Disorder. Results indicated that several measures of repetitive behaviour, particularly more complex high-level ones, were significantly positively associated with the probability of receiving a diagnosis of autism. No significant relationships were found between developmental age and the presence of repetitive behaviours in children with autism, but younger chronological age was associated more with simple or low-level repetitive behaviours.

Efficacy of sensory and motor interventions for children with autism

Idiosyncratic responses to sensory stimuli and unusual motor patterns have been reported clinically in young children with autism. The etiology of these behavioral features is the subject of much speculation. Myriad sensory- and motor-based interventions have evolved for use with children with autism to address such issues; however, much controversy exists about the efficacy of such therapies. This review paper summarizes the sensory and motor difficulties often manifested in autism, and evaluates the scientific basis of various sensory and motor interventions used with this population. Implications for education and further research are described.

Are infants with autism socially engaged? A study of recent retrospective parental reports

The purpose of this study was to identify the specific aspects of social engagement that distinguish infants with autism from infants of similar age and developmental level who do not have autism. Ten parents of preschoolers with autism and 10 parents of matched children without autism were given a semistructured interview, the Detection of Autism by Infant Sociability Interview (DAISI), which elicits reports on whether 19 aspects of social engagement characteristic of typically developing infants were present at some time during the child's first 24 months. The reports of infants with autism differed from those of the control group on 16 items. Findings suggest that infants with autism have marked limitation in both person-to-person and person-person-object social engagement, in keeping with the theory that autism involves impairments in primary as well as secondary intersubjectivity (Hobson, 1993a).

A structured parent interview for identifying young children with autism

This study evaluated the psychometric properties of the Parent Interview for Autism (PIA), a structured interview for gathering diagnostic information from parents of young children with autism. Internal consistency was evaluated in a sample of 165 children under 6 years old, and test-retest reliability and construct validity were evaluated in subsamples of the original group. Results revealed internal consistency and test-retest reliability above .60 for 9 of the 11 dimensions constituting the PIA, as well as significant correlations between the PIA and other measures of autism. Six of the PIA dimensions differentiated a group of young children with autism from a developmentally comparable group with mental retardation. Implications of these findings and suggestions for future research are discussed.