26015
Social Responsiveness at 12 and 15 Months Predicts Severity of Social Deficits at 4 Years in Infant Siblings
Social skills deficits (e.g. joint attention and empathy) that are characteristic of Autism Spectrum Disorder (ASD) emerge early in infancy and are evident before children receive formal diagnoses (Dawson et al., 2004). These early deficits may impact subsequent social skills development (Mundy & Neal, 2001). Therefore, it is important to identify which early deficits, at what age, are related to subsequent social functioning. Understanding if these early social skills deficits predict later social deficits is crucial for building a developmental model of ASD, identifying target areas for intervention, and establishing a timeframe for beginning early interventions.
Objectives:
Identify the extent to which social responses (joint attention skills and responses to examiner’s distress) at 12 and 15 months predict the severity of social deficits at four years.
Methods:
Eleven high-risk and 19 low-risk infant siblings were assessed longitudinally at 12 and 15 months of age for: 1) Attention and Affect responses to a standard empathy paradigm (Hutman et al., 2010), 2) Responding to and Initiating Joint Attention (RJA and IJA, respectively; Early Social Communication Scales; Mundy et al., 2003). Additionally, mothers later completed the Social Responsiveness Scale (SRS-2; Constantino, 2012) when infants were 4 years old (mean age= 49.0 months). Linear regressions, with the SRS-2 total severity score (SRS_Total) as the outcome, were conducted separately for RJA, IJA, Attention, and Affect as predictors at each age (12 and 15 months). Risk status was included as an additional predictor in each model to determine if early deficits were predictive of social deficits, beyond known risk effects.
Results:
At 12 months, significant negative effects of Attention (p<0.001) and Affect (p=0.048) on SRS-2 Total scores were observed. At 15 months, significant negative effects of Attention (p=0.005) and RJA (p=0.046) and a marginally significant effect of Affect (p=0.056) on SRS-2 Total scores were observed. These findings suggest that infants who paid less attention to the examiner in distress at 12 and/or 15 months, who displayed less affect towards the examiner in distress at 12 and/or 15 months, and/or who failed to respond to the examiner’s request for joint attention at 15 months were reportedly exhibiting greater social deficits at 4 years.
Conclusions:
Consistent with theory, the results of our study indicate that observed social deficits in infancy predicted parent report of social deficits in early childhood. Specifically, we found that failing to respond to either a social partner’s: (1) distress, or (2) attention significantly predicted greater social impairment 3 years later. Our data would suggest that any early failures to respond to social partner may be important markers of social developmental risk that should be closely monitored and/or be considered intervention targets.