Does 24-Month Empathic Responding Predict Autistic Symptomatology and Later ASD Diagnosis?

Background: There is evidence that individuals with Autism Spectrum Disorders (ASDs) have deficits in recognizing and responding to other’s emotional experiences. In typically developing individuals, the ability to connect with other’s emotions, or empathize, is associated with increased social competence. Consequently, it may be that a disturbance in the ability to empathize in people with ASDs contributes to the social and communication deficits that define the disorder. Despite the potential relevance of empathy deficits, little is known about how early empathic responding relates to autistic symptomatology and eventual diagnosis. The current study used a prospective method to investigate early empathic responding in younger siblings of children with an ASD, who are at increased genetic risk for the disorder, and children with typically developing older siblings.

Objectives: To investigate whether early empathic responding predicts later autistic symptomatology and ASD diagnosis.

Methods: Children at varying risk for an ASD were measured for empathic responding at 24 months and autistic symptomatology at 30 and 36 months. Empathic responding was measured from children’s responses to parental distress during a free play session. Children were given an overall Empathy rating from 1 to 7. Autistic symptomatology was measured with the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview (ADI). Participants were later diagnosed by an independent clinician, according to DSM-IV criteria, as having Autistic Disorder (AD), Pervasive Developmental Disorder – Not Otherwise Specified (PDD), or No ASD.

Results: Preliminary analyses were conducted with 24-month Empathy rating and 30-month ADOS score. Empathy rating at 24 months predicted 30-month ADOS score, F(1,24)=5.13,p<.05, explaining 18% of the variance, so that children displaying less early empathic responding showed more autistic symptomatology on the ADOS. Preliminary analyses were also conducted with 24-month Empathy and eventual diagnosis. For this analysis, AD and PDD diagnoses were collapsed into one ASD group and compared to the No ASD group. The children later diagnosed with an ASD (M=1.90, SD=0.99, n=10) had lower 24-month Empathy ratings than the No ASD group (M=3.60, SD=1.58, n=10), F(1,18)=8.31,p=.01. A linear regression analysis with 24-month Empathy and 36-month ADI score will also be conducted.

Conclusions: This is the first study to look prospectively at early empathy development in children with ASDs. Results of preliminary analyses demonstrate that children who are later diagnosed with an ASD display less empathic responding than children with no ASD at 24 months of age, and that 24-month empathic responding predicts later ASD symptomatology, as measured by the ADOS. These results suggest that empathic responding around two years of age may be an important marker for future ASD diagnosis. Further analyses will be conducted as sample size increases.