European Child & Adolescent Psychiatry

, Volume 23, Issue 3, pp 143–149 | Cite as

Infant’s engagement and emotion as predictors of autism or intellectual disability in West syndrome

  • Lisa Ouss
  • Catherine Saint-Georges
  • Laurence Robel
  • Nicolas Bodeau
  • Marie-Christine Laznik
  • Graciela C. Crespin
  • Mohamed Chetouani
  • Claude Bursztejn
  • Bernard Golse
  • Rima Nabbout
  • Isabelle Desguerre
  • David CohenEmail author
Original Contribution


West syndrome (WS) is a rare epileptic encephalopathy with early onset and a high risk of autistic outcome. The PréAut grid assesses this risk following WS onset by taking into account synchrony and emotion in interactions and by evaluating the baby’s active desire to engage in pleasant interactions (especially the infant’s early active behaviors that encourage being gazed at or kissed by the mother or to share joy with her). We followed a sample of 25 WS patients prospectively from disease onset and assessed whether the PréAut grid before 9 months, and the checklist for autism in toddlers (CHAT) at 18 and 24 months predicted autism or intellectual disability (ID) outcomes at 4 years. We found that the PréAut grid at 9 months (sensitivity = 0.83; specificity = 1) had similar prediction parameters as the CHAT at 18 months (sensitivity = 0.90; specificity = 0.83) and 24 months (sensitivity = 0.92; specificity = 1). WS patients with a positive PréAut screening at 9 months had a risk of having autism or ID at 4 years, which is 38 times that of children with a negative PréAut grid [OR = 38.6 (95 % CI 2.2–2961); p = 0.006]. We conclude that the PréAut grid could be a useful tool for the early detection of autism or ID risk in the context of WS. Further research is needed to assess the PréAut grid in other contexts (e.g. infants at high-risk for non-syndromic autism).


Autism Intellectual disability West syndrome Outcome Risk assessment 



The authors thank all of the patients and families who participated in this study. The study was funded by the EADS foundation (PILE) by the Agence Nationale de la Recherche (ANR-12-SAMA-006-1) and the Groupement de Recherche en Psychiatrie (GDR-3557).

Conflict of interest

The authors have no conflicts of interest.

Supplementary material

787_2013_430_MOESM1_ESM.ppt (157 kb)
Supplementary online Figure S1. Diagram flow of the study and diagnostic at FU (PPT 157 kb)
787_2013_430_MOESM2_ESM.ppt (176 kb)
Supplementary online Figure S2. Admixture analysis of developmental quotient in toddlers with West syndrome (PPT 175 kb)
787_2013_430_MOESM3_ESM.doc (88 kb)
Supplementary online Annex S1 (DOC 88 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lisa Ouss
    • 1
  • Catherine Saint-Georges
    • 2
    • 3
  • Laurence Robel
    • 1
  • Nicolas Bodeau
    • 2
  • Marie-Christine Laznik
    • 4
  • Graciela C. Crespin
    • 5
  • Mohamed Chetouani
    • 3
  • Claude Bursztejn
    • 6
  • Bernard Golse
    • 1
  • Rima Nabbout
    • 7
  • Isabelle Desguerre
    • 7
  • David Cohen
    • 2
    • 3
    Email author
  1. 1.Service de Psychiatrie de l’EnfantAP-HP, Hôpital NeckerParisFrance
  2. 2.Département de Psychiatrie de l’Enfant et de l’AdolescentAP-HP, Hôpital Pitié-SalpêtrièreParis Cedex 13France
  3. 3.ISIR, CNRS, UMR 7222, UMPCParis CedexFrance
  4. 4.Department of Child and Adolescent PsychiatryAssociation Santé Mentale du 13èmeParisFrance
  5. 5.PREAUT AssociationParisFrance
  6. 6.Department of Child and Adolescent PsychiatryHopitaux Universitaires de StrasbourgStrasbourgFrance
  7. 7.Service de NeuropédiatrieAP-HP, Hôpital NeckerParisFrance

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