We investigated gesture production in infants at high and low risk for autism spectrum disorder (ASD) and caregiver responsiveness between 12 and 24 months of age and assessed the extent to which early gesture predicts later language and ASD outcomes. Participants included 55 high-risk infants, 21 of whom later met criteria for ASD, 34 low-risk infants, and their caregivers. Results indicated that (a) infants with ASD outcomes used fewer gestures and a lower proportion of developmentally advanced gesture–speech combinations; (b) caregivers of all the infants provided similar rates of contingent responses to their infants’ gestures; and (c) gesture production at 12 months predicted subsequent receptive language and ASD outcomes within the high-risk group.
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There was no group difference in mean lengths of caregiver-infant interaction videos (HRA+: M = 9.21, SD = 1.90; HRA-: M = 9.31, SD = 2.25; LRC: M = 9.77, SD = 2.04).
We conducted a sensitivity analysis in which we removed data from four high-risk infants whose ASD outcomes were determined at 18 months. We found the same results even after we removed data from these infants.
Of note, caregiver education was also significantly and negatively associated with ASD diagnosis, such that infants whose parents had higher levels of education had a lower probability of receiving ASD diagnosis later. This finding, however, contrasts with previous findings that reported a positive association between maternal education and rates of ASD in the United States (e.g., Fountain et al. 2011), and is difficult to interpret considering that we have limited information on potential confounders of parental education and that parents of both HRA + and HRA- infants had relatively high levels of education in the current study (Table 6). Further research may help elucidate potential mechanisms of association between parental education and ASD within a high-socioeconomic sample.
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We would like to thank all children and families who participated in this study as well as the former and current Infant Sibling Project team members for their help in the data collection. We also thank two anonymous reviewers for their constructive feedback on an earlier version of the manuscript, Kathryn A. Leech for training on transcription, and Phoebe Stoye for assistance with transcription. This work was presented at the 2018 International Society for Autism Research, Rotterdam, Netherlands. This manuscript was prepared from part of a doctoral dissertation completed by Boin Choi.
This study was funded by the grants from the National Institutes of Health (R01-DC010290 to HTF and CAN; R21-DC08637 to HTF), Autism Speaks (1323 to HTF), and Simons Foundation (137186 to CAN). The funding bodies did not have any role in the design, collection, analyses, and interpretation of data or in writing the manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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Choi, B., Shah, P., Rowe, M.L. et al. Gesture Development, Caregiver Responsiveness, and Language and Diagnostic Outcomes in Infants at High and Low Risk for Autism. J Autism Dev Disord 50, 2556–2572 (2020). https://doi.org/10.1007/s10803-019-03980-8
- Receptive language
- Infant siblings