International Meeting for Autism Research (May 7 - 9, 2009): Screening with the First Year Inventory at 12 Months of Age and Diagnostic Outcomes at Two Years in a High-Risk Sample of “Infant Sibs”
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Screening with the First Year Inventory at 12 Months of Age and Diagnostic Outcomes at Two Years in a High-Risk Sample of “Infant Sibs”

Thursday, May 7, 2009: 1:30 PM
Northwest Hall Room 5 (Chicago Hilton)
G. T. Baranek , Allied Health Sciences - Division of Occupational Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
L. Zwaigenbaum , Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
J. Brian , Autism Research Unit & Bloorview Research Institute, Hospital for Sick Children & Bloorview Kids Rehab, Toronto, ON, Canada
S. E. Bryson , Pediatrics and Psychology, Dalhousie University/IWK Health Centre, Halifax, NS, Canada
E. Crais , Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
J. Piven , Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC
J. S. Reznick , Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC
W. Roberts , Department of Pediatrics, Hospital for Sick Children & Bloorview Kids Rehab, University of Toronto, Toronto, ON, Canada
I. M. Smith , Pediatrics & Psychology, Dalhousie University & IWK Health Centre, Halifax, NS, Canada
P. Szatmari , The Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
L. Watson , Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: Longitudinal studies of infant siblings of children with ASD provide a unique opportunity to determine the validity of infant screening tools in a high-risk sample (Zwaigenbaum et al., 2007). The First Year Inventory (FYI) ( Baranek, Watson, Crais & Reznick, 2003) is a parental report measure designed to screen 12-month old infants at-risk for ASD or related DD. Developed from research on early features of ASD, the FYI has 61 items, and taps 8 constructs within two broad domains -- sensory-regulatory & social-communication functions.

Objectives: This study aims to test the validity of the FYI in predicting clinical diagnoses of ASD at age two in a high-risk “infant sibs” sample.

Methods: 111 infant sibs and 37 typically-developing controls were assessed with the FYI at 12 months. The original FYI scoring model (Reznick et al., 2007) was used and outcomes were divided into three risk ranges (high: ≥93%ile; moderate: 80-92%ile; low: <80%ile). A research team including a pediatrician and a clinical psychologist, blind to FYI score, conducted developmental (Mullen,) and diagnostic (ADOS) evaluations to determine clinical diagnoses (DSM-IV) at age 2. Thus far, complete data were available for 77 sibs and 30 controls.

Results: At 12 months of age, infant sibs had significantly elevated FYI raw scores and risk percentiles (M=13.57; 74%ile) relative to controls (M=5.14; 35%ile), [t(146)=4.98, p<.001]. Scores of controls were comparable to the normative sample. At 2 years of age, 16 (21%) sibs received an ASD diagnosis, 7 (9%) sibs received a diagnosis of language delay, and 23 (30%) sibs had other concerns, whereas 31 (40%) had no concerns. Using an FYI cutoff of ≥93%ile, 9/16 (56.2%) “ASD” sibs scored in this high-risk range, whereas, another 3 (18.8%) “ASD” sibs scored between 80 and 92%iles (moderate-risk range). Using the high-risk cutoff for ASD, sensitivity was 56.2% and specificity was 70.5% in this sample. Using the moderate-risk cutoff for ASD, sensitivity increased to 75% and specificity decreased to 37.7%. Further analyses of these data are in progress to determine the best cutoffs for 12-month screening.

Conclusions: The preliminary results from this longitudinal study support the utility of the FYI as an effective parent-report screening tool for 12-month old infants at-risk for ASD in a high-risk infant sibs sample. Future research will identify specific items/constructs that are most predictive of various developmental and diagnostic outcomes, as well as look at trajectories to age three when clinical diagnosis for ASD is more stable.

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