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Relationship Between Early Social-Emotional Behavior and Autism Spectrum Disorder: A High-Risk Sibling Study

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Abstract

Social-emotional behavior in autism spectrum disorder (ASD) was examined among high-risk (HR; siblings of children diagnosed with ASD) and low-risk (LR; no family history of ASD) toddlers. Caregivers completed the Infant-Toddler Social Emotional Assessment (ITSEA) at 18 months, and blind diagnostic assessment for ASD was conducted at 36 months. Results indicated impairment in social-emotional functioning among HR toddlers subsequently diagnosed with ASD compared to other HR and LR toddlers, such that ITSEA domains (Internalizing, Dysregulation, Competence) and subdomains predicted later ASD symptoms and diagnosis. Receiver operating curves of optimal ITSEA cutoffs ranged from 0.23 to 0.44 for sensitivity, and 0.74 to 0.89 for specificity. Although classification accuracy for ASD was limited, group differences highlight the importance of considering social-emotional development when assessing ASD risk.

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Acknowledgments

The authors would like to thank all the families who participated in the research, as well as the research coordinators at each site. This study was supported by Women & Children’s Health Research Institute (WCHRI), Alberta Innovates-Health Solutions, Brain Canada, Kids Brain Health Network (formerly NeuroDevNet), Canadian Institutes of Health Research (CIHR), Azrieli Foundation, and Stollery Children’s Hospital Foundation Chair in Autism.

Funding

This study was funded by Women & Children’s Health Research Institute (WCHRI), Alberta Innovates-Health Solutions, Brain Canada, Kids Brain Health Network (formerly NeuroDevNet), Canadian Institutes of Health Research (CIHR), Azrieli Foundation, and Stollery Children’s Hospital Foundation Chair in Autism.

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Authors and Affiliations

  1. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Sarah Raza, Lori-Ann R. Sacrey & Lonnie Zwaigenbaum

  2. Autism Research Centre (E209), Glenrose Rehabilitation Hospital, 10230 – 111 Avenue, Edmonton, AB, T5G 0B7, Canada

    Sarah Raza, Lori-Ann R. Sacrey & Lonnie Zwaigenbaum

  3. Dalhousie University/IWK Health Centre, Halifax, NS, Canada

    Susan Bryson & Isabel M. Smith

  4. Bloorview Research Institute, Toronto, ON, Canada

    Jessica Brian

  5. University of Toronto, Toronto, ON, Canada

    Jessica Brian & Peter Szatmari

  6. ISAND, Toronto, ON, Canada

    Wendy Roberts

  7. The Hospital for Sick Children, Toronto, ON, Canada

    Peter Szatmari

  8. Centre for Addiction and Mental Health, Toronto, ON, Canada

    Peter Szatmari

  9. University of Ottawa, Ottawa, ON, Canada

    Tracy Vaillancourt

  10. McMaster Children’s Hospital – Hamilton Health Sciences, Hamilton, ON, Canada

    Caroline Roncadin

  11. Mount Allison University, Sackville, NB, Canada

    Nancy Garon

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  1. Sarah Raza
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  2. Lori-Ann R. Sacrey
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  3. Lonnie Zwaigenbaum
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  4. Susan Bryson
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  8. Peter Szatmari
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  9. Tracy Vaillancourt
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  11. Nancy Garon
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Contributions

SR made substantial contributions to the conception and design of the paper, analyzed data, and prepared all drafts of the paper. LRS, LZ, SB, JB, IMS, WR, PS, TV, CR, and NG contributed to the conception of the project, provided critical review of the manuscript, and approved the final draft.

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Correspondence to Sarah Raza.

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Raza, S., Sacrey, LA.R., Zwaigenbaum, L. et al. Relationship Between Early Social-Emotional Behavior and Autism Spectrum Disorder: A High-Risk Sibling Study. J Autism Dev Disord 50, 2527–2539 (2020). https://doi.org/10.1007/s10803-019-03977-3

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