20664
Parental Concerns and Their Relation to Early Intervention and Social-Communicative Functioning within the First Two Years of Life
Parental concerns about a toddler’s development may serve as a catalyst for seeking guidance, diagnostic evaluations, and/or early intervention services. For children diagnosed with ASD, on average, parents report becoming concerned about their child’s development by 18 months. However, little is known about how these concerns develop, whether they prompt parents to seek early intervention services for their toddlers, and the extent to which they predict toddlers’ later social-communicative functioning. The current study examined the presence of parental concerns in infants at risk for ASD with an ASD diagnosis (Sibs-HR/ASD), at risk but without an ASD diagnosis (Sibs-HR/ND), and low risk controls (Sibs-LR).
Objectives:
Examine: 1) change in parental concerns between 12 and 18 months, 2) the extent to which parental concerns at 18 months increase the likelihood that toddlers are enrolled in intervention services at 18 months, and 3) the extent to which parental concerns at 18 months predict childrens’ language and social-communication at 24 months.
Methods:
Sibs-HR/ASD (n=21), Sibs-HR/ND (n=39), and LR-sibs (n=41) were examined at 12, 15, 18, and 24 months. At 12-18 months, parental concerns were calculated by summing parent’s responses indicating level of concern (i.e., 0=no, 1=a little, 2=yes) across the 7 items on the Parent Concern Form, which focuses on motor, language, and social behaviors. At 18 months, toddlers were identified as receiving early intervention; 12 Sibs-HR/ASD, 4 Sibs-HR/ND, and 3 LR-sibs were receiving services per the Child Treatment Questionnaire. At 24 months, expressive and receptive language were measured via T-scores on the Mullen, and social-communication was measured via Vineland standardized Communication and Socialization scores.
Results:
For parental concerns, a repeated-measures ANOVA yielded significant main effects for Age and Diagnostic Group, and their interaction, ps<.01 (see Table 1). Post-hoc analyses indicated that: (1) at 12 months, parental concerns were significantly higher for Sibs-HR/ASD and Sibs-HR/ND than Sibs-LR, ps<.03; (2) at 15 and 18 months, parental concerns were significantly higher for Sibs-HR/ASD than Sibs-HR/ND and Sibs-LR, ps<.01; and (3) for Sibs-HR/ASD only, parental concerns significantly increased between 12 and 18 months, p<.02. A logistic regression indicated that, across all toddlers, higher levels of parental concerns at 18 months increased the likelihood that early intervention services were being received,OR=1.51, p<.01.
For Sibs-HR/ASD, higher levels of parental concerns at 18 months predicted lower levels of receptive language (r=-.49), communication (r=-.65), and socialization (r=-.59) at 24 months. For Sibs-LR, higher levels of parental concerns at 18 months predicted lower levels of expressive language, r=-.31.
Conclusions:
At 1 year of age, parents of Sibs-HR were more concerned about their infant’s development than Sibs-LR parents; however, concerns significantly increased over the following 6 months only for those Sibs-HR who received an ASD diagnosis at age 2. The presence of concerns increased the likelihood that toddlers would be receiving intervention by 18 months. While parental concerns predicted lower levels of expressive language for Sibs-LR, they predicted both language and social outcomes for HR-sibs/ASD, suggesting that early developmental concerns may map on more closely to later ASD-specific deficits for these toddlers.