Social and Communicative Deficits in the First Year of Life; Prediction of Later Diagnosis

Background:

Autism is a behavioural, developmental disorder characterized by abnormal social interaction, disordered communication and lack of imaginative play. It is regarded as the most severe psychiatric disorder in childhood, but is rarely diagnosed before 3 years despite the fact that the majority of cases have a symptom onset during infancy.
A diagnosis of autism is generally based on information derived from both parental reports and clinical observation. However certain key behaviours may not readily be observed in a clinical setting during a brief and highly structured visit. It is therefore of importance to identify which behavioural features that reliably can be describe by the parents and that are of relevance for an early diagnosis of autism.

Objectives:

Explore whether most parents of children with a suspected autismspectrumdisorder (ASD) report similar developmental concerns the first year of life?  Explore whether parents of children with ASD report different types of early concerns than parents of children with other developmental problems?

Methods:

The sample consists of 94 children (75 boys, 19 girls) consecutive referred for suspected autism spectrum disorders. Mean chronological age is 6,8 years (SD 3,1). At referral parents are asked to rate their child’s current behaviour. In addition they are asked to retrospectively rate their child’s behaviour before their second birthday. Both the children’s social and communicative competencies as well as presence of abnormality in the first two years were rated.  Forty parents were asked to complete the checklists twice for test-retest of information.

Results:

The parent’s early concerns about their child's early development are reported. Behaviour features reported the first two years in life are used to predict later development. Discriminant analysis is used to identify the behavioural features that best predicts the child's diagnostic status.  

Conclusions:

No single behavioural feature is unique for ASD in early development. A combination of behavioural features reported earlier than two years of age seemed to best predict a diagnosis within the autismspectrum.