International Meeting for Autism Research (May 7 - 9, 2009): Can Early Signs of Autism Spectrum Disorders (ASD) Predict Social-Communicative, Play and General Development in Toddlers with and without ASD?

Saturday, May 9, 2009

Northwest Hall (Chicago Hilton)

10:00 AM

M. Dereu , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

M. Meirsschaut , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

G. Pattyn , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

R. Raymaekers , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

I. Schietecatte , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

P. Warreyn , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

H. Roeyers , Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

Background: Research has indicated problems in language, cognitive development and social-communicative skills in young children with ASD.

Objectives: To examine if children with early signs of ASD are at risk for developmental and social-communicative problems.

Methods: 39 children who screened positive for ASD in a large screening study in Flemish day-care centres participated in a follow-up study. For these children (61.54% male; mean age = 22.78, SD=6.44) the Checklist for Early Signs of Developmental Disorders (CESDD) was filled out by a child care worker after following a 3-hour training about early signs of ASD. The Early Screening of Autistic Traits Questionnaire (ESAT) was filled out by one of the parents (N=37; 59.46% male; mean age=25.72, SD=7.84). About one year later (mean age=36.17, SD=6.47), the children were invited for further research with the Early Social Communication Scale (ESCS), the Test of Pretend Play (ToPP), the Preschool Imitation and Praxis Scale (PIPS) and the Mullen Scales of Early Learning (MSEL). Of these children, 21 were later diagnosed with ASD (53.8%). Children with and without ASD did not differ on total scores on the CESDD (t(37)=-0.776, p>.05), on the ESAT (t(35)=-1.939, p>.05) and on developmental quotient (t(37)= 1.357, p>.05). Children with ASD however, showed less behaviors to initiate joint attention (IJA) than children without ASD (t(37)= 2.349, p=0.024): they made less eye contact with the tester while holding a toy (t(37)=2.246, p=0.031) and pointed less to objects of interest with coordinated eye contact (t(37)=2.163, p=0.037). Children with ASD had a lower total score on the PIPS (t(35)=2.385, p=0.028) but their scores on the ToPP did not differ significantly from children without ASD (t(34)=1.567, p=0.126).

Results: Because this sample of children with and without ASD did not differ in amount of signs of ASD recognized on early screeners, we studied the predictive power of screening instruments in both groups for later assessment of IJA, imitation, pretend play and general development.
Passing or failing items regarding joint attention, imitation and pretend play on the screening instruments, could not predict outcome on the ESCS, PIPS or ToPP one year later. However, the total scores on the screeners could predict outcome on the MSEL: children with more signs of ASD at T1, had a lower developmental quotient at T2, regardless of their diagnosis (for CESDD: F(1,35)=5.933, p=0.02; for ESAT: F(1,33)=7.297, p=0.011). Also, there was a significant interaction effect between diagnosis (ASD or not) and total score on the CESDD in predicting frequency of IJA behaviors at T2 (F(5,31)=2.451; p=0.05). This effect was mainly due to the frequency of IJA by pointing (F(1,35)=7.676; p=0.009).

Conclusions: Children with many signs of ASD seem to be at risk for general developmental and IJA problems one year later. The amount of early signs of ASD seems more important for later outcome than the nature of the signs.

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