Certain Behaviors May Predict Autism in High-Risk Children

childrenYoung children with an autistic sibling are often at high-risk to develop the disorder as well. Recently, researchers have studied three distinct behavior profiles in toddlers with autistic siblings to predict an autism diagnosis at age 3.

Researchers studied 719 children with autistic siblings. According to previous studies, these younger siblings are nearly 20 times more likely to develop autism than those without a family member on the spectrum. The researchers analyzed different behavior profiles associated with autism, such as difficulty making eye contact, repetitive behaviors, and lack of communicative gestures. Their findings point to multiple developmental pathways to the disorder, meaning that autism cannot truly be identified by a single behavior.

Study leader Katarzyna Chawarska, associate professor of pediatrics at Yale, states that clinicians should pay special attention to the combinations of behaviors that her team studied in 18-month old children. She adds, “I think the best way of identifying these children is to look for combinations of markers, not a single marker.”

Chawarska and her colleagues analyzed data from a randomly selected subgroup of 565 toddlers, with siblings on the autism spectrum. At the age of 3, 122 of these children were diagnosed with autism, 138 showed signs of social and/or cognitive delays, and 305 were neurotypical. They analyzed the children through a diagnostic test called the Autism Diagnostic Observation Schedule, and classified the children into three groups (typical, atypical, and autistic) based on their scores for six items.

Their analysis discovered that three behavioral combinations are a strong signal for an autism diagnosis. The first profile describes children who have difficulty making eye contact and communicating through gestures. Children with the second profile have difficulty making eye contact but do not engage in imaginative play. The third profile consists of children with just a bit of trouble making eye contact, but that show repetitive behaviors.

In total, their algorithm flagged 57 percent of the children that were later diagnosed with autism. Their classification system was even more accurate at identifying typically developing siblings, indicating that the system is better at ruling out autism than fully detecting it. By studying combinations of behaviors, the algorithm improved the predictive value of a single behavior. For example, the study suggests that lack of eye contact alone is a poor indicator of autism. However, the presence of atypical eye contact in combination with nonverbal communication or lack of imaginative play can significantly increase the likelihood of autism.

Stelios Georgiades, assistant professor of psychiatry and behavioral neurosciences at McMaster University states, “By identifying the combination of symptoms and behaviors, we’re becoming more specific about what to look for”. The findings of this study suggest that siblings of children on the autism spectrum should undergo evaluations for the disorder periodically up to the age of 3. These evaluations can lead to an earlier diagnosis, allowing for earlier opportunities for therapies and optimal care.

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