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Observed Social Emotional Behavior at 22 Months Predicts a Later ASD Diagnosis in High-Risk Siblings

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Abstract

Social engagement, pretend play, and concern for another’s distress represent fundamental features of typical social-emotional development in the second year. Children with autism spectrum disorder (ASD) display delays and deficits in these areas, and research on toddlers at heightened risk for ASD (HR; younger siblings of children with ASD) indicates these deficits may be apparent in toddlerhood. Prior research has examined these aspects of social-emotional development individually in HR toddlers. The present paper examines them jointly as predictors of ASD. We show that social engagement, pretend play, and empathic concern at 22-months each contribute uniquely to predicting later ASD diagnosis with high specificity and moderate sensitivity. Results have important implications for early diagnosis and intervention in young children with ASD.

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Notes

  1. Analyses were originally run without doing this second standardization of composite scores; however, this made interpretation of results significantly more cumbersome. The re-standardizing of composite scores does not change any results, but allows us to interpret one-unit differences as one standard deviation differences, making results much more interpretable.

  2. Note that the odds ratios reported in Table 3 are the odds of having ASD given scores 1 SD higher than the mean. In order to report on the odds ratio of having ASD given scores 1 SD lower than the mean, we took the inverse of the odds ratio (1/odds ratio).

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Acknowledgments

This study was supported by the National Institute of Mental Health R01 MH091036 to Dr. Campbell. We thank Dr. Nancy Minshew, Dr. Mark Strauss, Dr. Carla Mazefsky, Dr. Holly Gastgeb, Ms. Stacey Becker, and the staff at Autism Center of Excellence, University of Pittsburgh for overseeing initial recruitment and assessment of participating families. The Autism Center of Excellence was supported by award number HD055748 (PI Minshew) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Recruitment was also facilitated by the Clinical and Translational Science Institute, supported by the National Institutes of Health through Grant Numbers UL1 RR024153 and UL1TR000005. Thanks are due to Taylor Day, Kristen Decker, Stephanie Fox, Phebe Lockyer, Amanda Mahoney, Elizabeth Moore, and Emily Schmidt for overseeing data collection and coding, and to Ari Fish, Rachel Fleming, Monica Kim, Kristen McMillen, Michelle Meyer, Jenna Obitko, and Amy Tavares for assisting with coding. Special thanks go to the parents and children who participated in this study.

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Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Jessie B. Northrup & Nina B. Leezenbaum

  2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA

    Susan B. Campbell

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  1. Jessie B. Northrup
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  2. Nina B. Leezenbaum
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  3. Susan B. Campbell
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All authors contributed to the conceptualization and design of the current paper. SBC was responsible for the overall conduct and conceptualization of the larger longitudinal study. JBN analyzed the data and prepared an initial draft of the manuscript. All coauthors read, edited, and approved the manuscript.

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Correspondence to Jessie B. Northrup.

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Northrup, J.B., Leezenbaum, N.B. & Campbell, S.B. Observed Social Emotional Behavior at 22 Months Predicts a Later ASD Diagnosis in High-Risk Siblings. J Autism Dev Disord 51, 3187–3198 (2021). https://doi.org/10.1007/s10803-020-04789-6

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