Use of Written Diaries in Tracking the Language Development in Infants at Risk for ASD

Background:
Parental reporting has been viewed as an important source of information in studying the development of infants who are later diagnosed with ASD. However, retrospective parental reporting can be affected by distortion of recall. Therefore, as an alternative, written diaries may be used to collect data frequently during the early stages of development in order to identify delays in language and communication as they develop.

Objectives:
To examine the effectiveness of written diaries as a novel approach for studying the development of infants at risk for ASD.

Methods:
In an ongoing study, there are three groups of participants ¾infants at risk for ASD, infants at risk for specific language impairment (SLI), and typically-developing controls. Parents were asked to complete written diaries on a weekly basis, either though an online database or on paper, beginning when their infant turned 6 months old, and continuing until their infant reached 18 months of age. Parents were also asked to complete monthly home video diaries during this age range as well as come into the laboratory to be seen with their infants at 6, 9, 12, 18, 24 and 36 months. 

Results:
On average, ASD-risk families (n=31) submitted 11.7 diaries each throughout the 12-month period, SLI-risk (n=6) families submitted 23 diaries each, and control families (n=24) submitted 11.7 dairies each. Preliminary analysis suggests that all three groups developed consonants within the age range of 7 to 9 months. ASD-risk infants who were later diagnosed with ASD developed words about 3 months later than ASD-risk infants who did not receive diagnoses. Parents of ASD-risk infants also expressed more concerns than parents of SLI-risk infants and parents of control infants. Ongoing work will focus on the differences found in the diaries between ASD-risk infants who later meet criteria for ASD and ASD-risk infants who do not meet criteria for ASD. The correlation between behaviors reported by parents and behaviors seen in standardized assessments will also be evaluated. 

Conclusions:
Thus far, our results suggest that families are capable of completing at least one written diary per month, enabling us to collect data more frequently and in a cost-effective way. Written dairies may also help us to identify delays in language development in ASD-risk and SLI-risk infants.