Behavioural Inhibition As a Predictor of Anxiety Problems Among Children at Risk for Autism Spectrum Disorders

Thursday, May 11, 2017: 5:30 PM-7:00 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
M. Ersoy1,2, G. Pasco3, C. H. Cheung4, T. Gliga5, E. Jones6, T. Charman7, M. H. Johnson5 and T. B. Team8, (1)Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, London, United Kingdom of Great Britain and Northern Ireland, (2)King's College London, London, United Kingdom, (3)Institute of Psychiatry, London, UNITED KINGDOM, (4)Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UNITED KINGDOM, (5)Centre for Brain and Cognitive Development, Birkbeck University of London, London, United Kingdom, (6)Birkbeck, University of London, London, UNITED KINGDOM, (7)Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom, (8)Birkbeck College London, London, United Kingdom
Background:  Anxiety problems are highly prevalent among children and adolescents with autism spectrum disorder (ASD). However the constructs that lead to heightened levels of anxiety in ASD remain poorly understood. In typically developing children, behavioural inhibition (BI) in the early years, which refers to initial reactions of wariness, fearfulness and shyness in unfamiliar contexts, has been identified as a robust predictor of anxiety problems in later childhood. However, there has been no investigation of BI and its correlates with anxiety problems among children at risk for ASD.

Objectives:  This prospective longitudinal study aims to explore whether elevated levels of anxiety are observed among infants at heightened familial risk of ASD (HR; due to having an older sibling with a diagnosis of ASD) compared to infants at low-risk (LR; having an older sibling without ASD). Parent-report measures of BI are obtained at 8, 14 and 24 months of age and used to investigate associations between BI and anxiety problems at 36 months.

Methods:  The sample in this study includes 113 HR and 27 LR children. Of the 113 HR infants, 17 met DSM-5 criteria for ASD (HR-ASD), 32 participants did not meet clinical criteria for ASD but presented with other atypicalities (HR-Atypical), and 64 participants were typically-developing (HR-TD). BI was measured using the fearfulness subscale of the Infant Behaviour Questionnaire (IBQ) at 8 and 14 months and the fearfulness and shyness subscales of Early Childhood Behaviour Questionnaire (ECBQ) at 24 months. Anxiety problems were measured with the Child Behaviour Checklist (CBCL) at 36 months.

Results: There was a significant difference between outcome groups in anxiety scores Fw (3, 45) = 5.82, p<.001. Post-hoc comparisons showed that the HR-ASD group exhibited significantly higher anxiety scores than the LR group (d= 1.26, p= .001) and HR-TD group (d = 0.99, p= .001). There was a positive and significant association between BI scores at 8 (r=.30, p =.002), 14 (r=.35, p <.001) and, 24 (r=.48, p <.001) months and anxiety problems at 36 months. Conclusions:  Children who met ASD diagnosis at age three years were reported to have elevated anxiety scores in infancy compared to LR and HR-TD groups. There was a significant association between BI and anxiety scores and the effect of this association increased from 8 months to 24 months. These findings are important for our understanding of BI as a predictor of the neurodevelopmental emergence of the co-occurring anxiety problems that are common in children with ASD.