Journal of Autism and Developmental Disorders

, Volume 38, Issue 6, pp 1104–1111 | Cite as

Head Circumference as an Early Predictor of Autism Symptoms in Younger Siblings of Children with Autism Spectrum Disorder

  • Lauren M. Elder
  • Geraldine Dawson
  • Karen Toth
  • Deborah Fein
  • Jeff Munson
Original Paper


Siblings of children with autism have an increased risk for autism spectrum disorders (ASD). As children with autism often exhibit an atypical trajectory of head circumference (HC) growth, HC may be an indicator of vulnerability to autism. This study investigated whether infant siblings of children with ASD (n = 77) with an atypical trajectory of HC growth were more likely than those without an atypical HC trajectory to develop autism symptoms. Results showed that infants who had larger HC at 12 months, and whose HC growth rate decelerated more rapidly between 12 and 24 months were more likely to exhibit autism symptoms than infants with more typical HC trajectories. Among infant siblings of children with autism, atypical HC growth might alert pediatricians to provide screening and/or referral for further evaluation.


Autism Head circumference Infant siblings 


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington, DC: American Psychiatric Association.Google Scholar
  2. August, G. J., Stewart, M. A., & Tsai, L. (1981). The incidence of cognitive disabilities in the siblings of autistic children. British Journal of Psychiatry, 138, 416–422.PubMedGoogle Scholar
  3. Bailey, A., Phillips, W., & Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological and neurobiological perspectives. Journal of Child Psychology & Psychiatry, 37, 89–126.CrossRefGoogle Scholar
  4. Baird, T. D., & August, G. J. (1985). Familial heterogeneity in infantile autism. Journal of Autism and Developmental Disorders, 15, 315–322.PubMedCrossRefGoogle Scholar
  5. Baranek, G. T. (1999). Autism during infancy: A retrospective video analysis of sensory-motor and social behaviors at 9–12 months of age. Journal of Autism and Developmental Disorders, 29, 213–224.PubMedCrossRefGoogle Scholar
  6. Barthlomeusz, H. H., Courchesne, E., & Karns, C. M. (2002). Relationship between head circumference and brain volume in healthy normal toddlers, children, and adults. Neuropediatrics, 33, 239–241.CrossRefGoogle Scholar
  7. Bristol-Power, M. M., & Spinella, G. (1999). Research on screening and diagnosis in autism: A work in progress. Journal of Autism and Developmental Disorders, 29, 435–438.PubMedCrossRefGoogle Scholar
  8. Byrk, A. S., & Raudenbush, S. W. (2002). Hierarchical linear models: Applications and data analysis methods. Thousand Oaks: Sage.Google Scholar
  9. Cassel, T. D., Messinger, D. S., Ibanez, L. V., Haltigan, J. D., Acosta, S. I., & Buchman, A. C. (2007). Early social and emotional communication in the infant siblings of child with autism spectrum disorders: An examination of the broad phenotype. Journal of Autism and Developmental Disorders, 37, 122–132.PubMedCrossRefGoogle Scholar
  10. Chawarska, K., Paul, R., Klin, A., Hannigen, S., Dichtel, L. E., & Volkmar, F. (2007). Parental recognition of developmental problems in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 62–72.PubMedCrossRefGoogle Scholar
  11. Courchesne, E., Carper, R., & Akshoomoff, N. (2003). Evidence of brain overgrowth in the first year of life in autism. Journal of the American Medical Association, 290, 337–344.PubMedCrossRefGoogle Scholar
  12. Courchesne, E., Karns, C. M., Davis, H. R., Ziccardi, R., Carper, R. A., Tigue, Z. D., Chisum, H. J., Moses, P., Pierce, K., Lord, C., Lincoln, A. J., Pizzo, S., Schreibman, L., Haas, R. H., Akshoomoff, N. A., & Couchesne, R. Y. (2001). Unusual brain growth patterns in early life in patients with autistic disorder an MRI study. Neurology, 57, 245–254.PubMedGoogle Scholar
  13. Courchesne, E., & Pierce, K. (2005). Brain overgrowth in autism during a critical time in development: Implications for frontal pyramidal neuron and interneuron development and connectivity. International Journal of Developmental Neuroscience, 23, 153–170.PubMedCrossRefGoogle Scholar
  14. Cox, A., Charman, T., Baron-Cohen, S., Drew, A., Klein, K., Baird, G., Swettenham, J., & Wheelwright, S. (1999). Autism spectrum disorders and 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry, 40, 719–732.PubMedCrossRefGoogle Scholar
  15. Dawson, G., Munson, J., Webb, S. J., Nalty, T., Abbott, R., & Toth, K. (2007). Rate of head growth decelerates and symptoms worsen in the second year of life in autism. Biological Psychiatry, 15, 458–464.CrossRefGoogle Scholar
  16. De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Child & Adolescent Psychiatry, 7, 131–136.CrossRefGoogle Scholar
  17. Deutsch, C. K., & Joseph, R. M. (2003). Brief report: Cognitive correlates of enlarged head circumference in children with autism. Journal of Autism and Developmental Disorders, 33, 209–215.PubMedCrossRefGoogle Scholar
  18. Fidler, D. J., Bailey, J. N., & Smalley, S. L. (2000). Macroencephaly in autism and other pervasive developmental disorders. Developmental Medicine & Child Neurology, 42, 737–740.CrossRefGoogle Scholar
  19. Fombonne, E. (2005). The changing epidemiology of autism. Journal of Applied Research in Intellectual Disabilities, 18, 281–294.CrossRefGoogle Scholar
  20. Gamliel, I., Yirmiya, N., & Sigman, M. (2007). The development of young siblings of children with autism from 4 to 54 months. Journal of Autism and Developmental Disorders, 37, 171–183.PubMedCrossRefGoogle Scholar
  21. Gillberg, C., & de Souza, L. (2002). Head circumference in autism, Asperger syndrome, and ADHD: A comparative study. Developmental Medicine and Child Neurology, 44, 296–300.PubMedCrossRefGoogle Scholar
  22. Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 21, 281–290.CrossRefGoogle Scholar
  23. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.Google Scholar
  24. Lord, C. (1995). Follow-up of two year-olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365–1382.PubMedCrossRefGoogle Scholar
  25. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701.PubMedCrossRefGoogle Scholar
  26. Lord, C., Schopler, E., & Revicki, D. (1982). Sex differences in autism. Journal of Autism and Developmental Disorders, 12, 317–330.PubMedCrossRefGoogle Scholar
  27. Maestro, S., Muratori, F., Barbieri, F., Casella, C., Cattaneo, V., Cavallaro, M. C., Cesari, A., Milone, A., Rizzo, L., Viglione, V., Stern, D. D., & Palacio-Espasa, F. (2001). Early behavioral development in autistic children: The first 2 years of life through home movies. Psychopathology, 34, 147–152.Google Scholar
  28. Maestro, S., Muratori, F., Cavallaro, M. C., Pei, F., Stern, D., Golse, B., et al. (2002). Attentional skills during the first 6 months of age in autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1239–1245.PubMedCrossRefGoogle Scholar
  29. Mars, A. E., Mauk, J. E., & Dowrick, P. W. (1998). Symptoms of pervasive developmental disorders as observed in prediagnostic home videos of infants and toddlers. Journal of Pediatrics, 132, 500–504.PubMedCrossRefGoogle Scholar
  30. McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359–372.PubMedGoogle Scholar
  31. McGee, G. G., Morrier, M., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. Journal of the Association for Persons with Severe Handicaps, 24, 133–146.CrossRefGoogle Scholar
  32. Mitchell, S., Brian, J., Zwaigenbaum, L., Roberts, W., Szatmari, P., Smith, I., & Bryson, S. (2006). Early language and communication development of infants later diagnosed with autism spectrum disorder. Developmental and Behavioral Pediatrics, 27, S69–S78.CrossRefGoogle Scholar
  33. Mouridsen, S. E., Rich, B., & Isager, T. (2000). A comparative study of genetic and neurobiological findings in disintegrative psychosis and infantile autism. Psychiatry and Clinical Neurosciences, 54, 441–446.PubMedCrossRefGoogle Scholar
  34. Mraz, K. D., Green, J., Dumont-Mathieu, T., Makin, S., & Fein, D. (2007). Correlates of head circumference growth in infants later diagnosed with autism spectrum disorders. Journal of Child Neurology, 22, 700–713.PubMedCrossRefGoogle Scholar
  35. National Center for Health Statistics Center for Disease Control. (2002). Clinical growth charts. National Health and Nutrition Examination Survey [On-line]. Available:
  36. Osterling, J., & Dawson, G. (1994). Early recognition of children with autism: A study of first birthday home video tapes. Journal of Autism and Developmental Disorders, 24, 247–257.PubMedCrossRefGoogle Scholar
  37. Osterling, J. A., Dawson, G., & Munson, J. A. (2002). Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation. Development and Psychopathology, 14, 239–251.PubMedCrossRefGoogle Scholar
  38. Piven, J., Gayle, J., Chase, G. A., Fink, B., Landa, R., Wzorek, M. M., et al. (1990). A family history study of neuropsychiatric disorders in the adult siblings of autistic individuals. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 177–183.PubMedCrossRefGoogle Scholar
  39. Redcay, E., & Courchesne, E. (2005). When is the brain enlarged in autism? A meta-analysis of all brain size reports. Biological Psychiatry, 58, 1–9.PubMedCrossRefGoogle Scholar
  40. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144.PubMedCrossRefGoogle Scholar
  41. Rogers, S. J. (1998). Empirically supported comprehensive treatments for young children with autism. Journal of Clinical Child Psychology, 27, 168–179.PubMedCrossRefGoogle Scholar
  42. Scott, F. J., Baron-Cohen, S., Bolton, P., & Brayne, C. (2002). Brief report: Prevalence of autism spectrum conditions in children aged 5–11 years in Cambridgeshire, UK. Autism, 6, 231–237.PubMedCrossRefGoogle Scholar
  43. Smalley, S. L., Asarnow, R. F., & Spence, A. (1988). Autism and genetics. Archives of General Psychiatry, 30, 405–416.Google Scholar
  44. Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105, 269–285.PubMedCrossRefGoogle Scholar
  45. Sparks, B. G., Friedman, S. D., Shaw, D. W., Aylward, E. H., Echelard, D., Artru, A. A., et al. (2002). Brain structural abnormalities in young children with autism spectrum disorder. Neurology, 59, 184–192.PubMedGoogle Scholar
  46. Toth, K., Dawson, G., Meltzoff, A. N., Greenson, J., & Fein, D. (2007). Early social, imitation, play, and language abilities of young non-autistic siblings of children with autism. Journal of Autism and Developmental Disorders, 37, 145–157.PubMedCrossRefGoogle Scholar
  47. Veenstra-Vanderweele, J., & Cook, E. H. Jr. (2003). Genetics of childhood disorders: XLVI. Autism, part 5: Genetics of autism. Development and Neurobiology, 42, 116–118.Google Scholar
  48. Volkar, F. R., Szatmari, P., & Sparrow, S. S. (1993). Sex differences in pervasive developmental disorders. Journal of Autism and Developmental Disorders, 4, 579–591.CrossRefGoogle Scholar
  49. Werner, E., & Dawson, G. (2005). Validation of the phenomenon of autistic regression using home videotapes. Archives of General Psychiatry, 62, 889–895.PubMedCrossRefGoogle Scholar
  50. Werner, E., Dawson, G., Munson, J., & Osterling, J. (2005). Variation in early developmental course in autism and its relation with behavioral outcome at 3–4 years of age. Journal of Autism & Developmental Disorders, 35, 337–350.CrossRefGoogle Scholar
  51. Wiggins, L. D., Baio, J., & Rice, C. (2006). Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample. Journal of Developmental & Behavioral Pediatrics, 27, S79–S87.CrossRefGoogle Scholar
  52. Wing, L. (1981). Sex ratios in early childhood autism and related conditions. Psychiatric Research, 5, 129–137.CrossRefGoogle Scholar
  53. Woods, J. J., & Wetherby, A. M. (2003). Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder. Language, Speech, and Hearing Services and Schools, 34, 180–193.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Lauren M. Elder
    • 1
  • Geraldine Dawson
    • 1
    • 4
  • Karen Toth
    • 2
  • Deborah Fein
    • 3
  • Jeff Munson
    • 4
  1. 1.Department of Psychology, Autism CenterUniversity of WashingtonSeattleUSA
  2. 2.Children’s HospitalSeattleUSA
  3. 3.Department of PsychologyUniversity of ConnecticutStorrsUSA
  4. 4.Department of Psychiatry, Autism CenterUniversity of WashingtonSeattleUSA

Personalised recommendations