Predicting Toddlers' and Preschoolers' Attentional Skills and Sensory Features from Attentional Profiles on the First Year Inventory

Background:  The First Year Inventory (FYI; Reznick et al., 2007) is a parent questionnaire designed to detect 12-month-old infants at risk for a diagnosis of Autism Spectrum Disorders (ASDs). The current scoring metric, based on cut-off scores in social-communication and sensory-regulatory domains, is effective in detecting some infants who receive an ASD diagnosis, and others with developmental concerns; however, not all children who develop ASD could be detected with the FYI (Turner-Brown et al., 2012). Attentional differences and sensory response patterns are evident early in development for those diagnosed with ASDs. Exploring new dimensional constructs for the FYI may improve our understanding of different profiles that predict attentional and sensory differences, and risk for ASD and other developmental disorders, and can inform interventions.

Objectives:  The purpose of this study was to establish constructs of attention relevant to the development of ASDs using the FYI items, validate those constructs with clinical measures of attention and sensory features, and investigate their predictive value.

Methods:  We developed three new constructs from the original FYI items to tap dimensions of attention: (a) overfocused attention (OFA), (b) initiating joint attention (IJA), and (c) responding joint attention (RJA). Constructs were identified through literature reviews, theoretical considerations, and statistical analyses of an extant database with 7,823 FYIs. These constructs were further validated by analyzing assessments of attention and sensory features of 63 children (Mean Age = 14.14, SD = .78) who scored at risk on the FYI and were evaluated as part of a larger study. Correlational analyses of the new constructs were conducted with the Early Childhood Behavior Questionnaire (ECBQ; Putnam et al., 2006) and Sensory Experiences Questionnaire (SEQ; Baranek et al., 2006). Attention and sensory measures are being collected at ages 2 and 3 to demonstrate predictive validity of the new constructs, and explore relations with sensory features.

Results:  The new constructs demonstrate good Cronbach alpha coefficients: IJA (Alpha=0.763), RJA (Alpha=0.723), and OFA (Alpha=0.699). Positive, significant correlations (p<.0001) with the original FYI subdomains were found: IJA and RJA correlated more strongly with social-communication (r’s=0.673 and 0.758) than sensory-regulatory (r’s=0.163 and 0.265) risk. OFA correlated more strongly with sensory-regulatory (r=0.47) than social-communication (r=0.253) risk. All three constructs correlated positively and significantly (p<.0001) with overall risk, with RJA showing the strongest relation (r=0.649), followed by IJA (r=0.535) and OFA (r=0.432). RJA was significantly correlated with attention shifting on the ECBQ (r= -0.29, p<.05), and demonstrated a trend toward significance for Effortful Control (r=-0.22, p=0.09). RJA and OFA, were positively and significantly correlated with hyporesponsiveness on the SEQ (r=0.35, p=.007 and r=0.41, p=.001, respectively).

Conclusions: We found good internal consistency and convergent validity for three constructs tapping aspects of attention in 12-month-olds on the FYI. RJA and OFA were significantly related to hyporesponsiveness, supporting the idea that early-developing attention processes of engagement, disengagement and orienting to social and nonsocial stimuli may be associated with sensory issues. Future studies could use these attentional profiles to identify risk for ASDs and other developmental disorders, and inform the selection of intervention strategies.