Mid‐childhood outcomes of infant siblings at familial high‐risk of autism spectrum disorder

Abstract

Almost 20% of infants with an older sibling with autism spectrum disorder (ASD) exhibit ASD themselves by age 3 years. The longer‐term outcomes of high‐risk infants are less clear. We examined symptoms of ASD, attention‐deficit/hyperactivity disorder (ADHD) and anxiety, language, IQ, and adaptive behaviour at age 7 years in high‐ and low‐risk children prospectively studied since the first year of life. Clinical outcomes were compared between high‐risk children who met diagnostic criteria for ASD at age 7 (HR‐ASD‐7 group, n = 15), high‐risk children without ASD (HR‐Non‐ASD‐7 group, n = 24), and low‐risk control children (LR group, n = 37). Diagnostic stability between age 3 and 7 years was moderate, with five children who did not meet diagnostic criteria for ASD at age 3 years being assigned the diagnosis at age 7, and three children showing the opposite pattern. The HR‐ASD‐7 group showed elevated ADHD and anxiety symptoms and had lower adaptive behaviour scores than LR controls. The HR‐Non‐ASD‐7 group had higher repetitive behaviour, lower adaptive functioning and elevated scores on one anxiety subscale (Separation Anxiety) compared to LR controls, but evidence for subclinical ASD symptoms (the broader autism phenotype, BAP) was limited in the group as a whole, although we identified a subgroup with elevated ASD traits. The difficulties experienced by high‐risk siblings at school‐age extend beyond ASD symptoms. The pattern of difficulties exhibited by the HR‐ASD‐7 group may inform our understanding of developmental trajectories of co‐occurring psychopathology in ASD. Autism Res 2017, 10: 546–557. © The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research

Mapping Early Symptom Trajectories in Autism Spectrum Disorder: Lessons and Challenges for Clinical Practice and Science

“…The Worsening group had average non-verbal ability (NVIQ = 101) but considerably lower verbal ability (VIQ = 75) at baseline and both were higher than in the Moderately-improving and Severe-persistent groups. This is similar to the pattern reported in children with a later onset or emergence of ASD symptoms seen in familial high-risk sibling studies, both across a similar early preschool timeframe as in the present study 3 and in those who receive an ASD diagnosis in mid-childhood but did not when assessed at age 3 years 4,5,6 . One notable feature of the Worsening group was that despite having increasing ASD symptoms they showed considerable improvements in language and communication skills and adaptive abilities over time.…”

Inflexible neurobiological signatures precede atypical development in infants at high risk for autism

“…Our external validation analysis of data from 1,445 infants (~N = 945 HR and ~N = 500 LR) from representative UK and US high risk infant-sibling studies 25 – 28 confirms an atypical pattern of functioning as ascertained on Mullen and Vineland in HR infants, whether or not HR infants developed ASD later in life— specifically, lower scores relative to LR infants (Supplementary Figure 6 ). In particular, these data show non-overlapping 95% CIs of the mean of Mullen Early Learning Composite (ELC) score at a 2-year follow up as well as non-overlapping 95% CIs of the mean of Vineland Adaptive Behavior Composite (ABC) score at a 7-year follow up for HR ASD-negative siblings relative to LR infants; HR ASD-positive siblings showed the lowest scores.…”

Psychometric analysis of the repetitive behavior scale‐revised using confirmatory factor analysis in children with autism

“…Others have recognized the potential of the RBS‐R as a more ecological diagnostic measure of RRB in individuals with ASD and a tool for distinguishing RRB phenotypes in genetic research compared to the demands of the ADOS and ADI‐R [Bishop et al, ]. The convergent validity of the RBS‐R with the ADI‐R [Bishop et al, ] and research demonstrating significant differences between individuals with ASD and typically developing peers [e.g., Shephard et al, ; Van Eylen, Boets, Steyaert, Wagemans, & Noens, ; Wolff et al, ] and individuals with intellectual disability [e.g., Bodfish et al, ; Joseph, Thurm, Farmer, & Shumway, ] provides evidence of its potential diagnostic utility in conjunction with other gold standard measures. However, research on this topic is limited.…”