Head Lag in Infants At Risk for Autism

Background:    Delayed motor functioning in school-aged children with autism has been reported by numerous researchers, but limited research has focused on motor abnormalities during infancy  in this population.  Poor postural control, defined as poor head control while being pulled up from a supine position during pull to sit maneuver, has been documented to be an early predictor of developmental problems in other populations (e.g., cerebral palsy, preterm infants).  Postural control in infants at risk for ASD has not been examined in the literature to date.

Objectives:    We examined  the association between  head lag at 6 months of age in high risk infants and diagnosis of autism at 36 months. Next, we examined whether the presence of head lag is more prevalent in infants at high risk versus low risk infants for autism.

Methods: One sample of 40 high-risk infants (siblings of children with autism) was studied prospectively from 6-36 months; diagnostic classifications of autism or non-autism were obtained.  A subsequent between-group comparison was conducted with a new sample of 20 high- and 21 low-risk infants. 

Results:   Head lag was significantly associated with autism spectrum disorder at 36 months (p=0.02) and  was more frequently observed in high- than in low-risk infants (p=.018)

Conclusions: Although head lag is not specific to autism, it may be an early indicator that the nervous system is not developing appropriately in high risk infants. Results highlight the importance of early motor assessment in high risk infants for ASD. These findings may yield important information on early manifestation of autism which may lead to earlier medical screening and detection. This may result in earlier multidisciplinary intervention aiming to facilitate better outcomes in motor, social, and communicative development and minimize disabilities in children at high risk for autism.