Comparison of a Video-based Autism Spectrum Disorder Screening Tool in Infancy across High-Risk and Community Samples

• In Event: Using computer technology to expand detection and intervention for children with developmental disorders

Abstract

Background: There are multiple autism spectrum disorder (ASD) screening tools available, but few were developed for use in the first year of life. Although feasible for large-scale screening, written questionnaires rely on subjective interpretation and parental knowledge of developmental milestones, which may be challenging in infancy. We developed the Video-referenced Infant Rating System for Autism (VIRSA), an online screening measure that depicts a range of social-communication ability in infants 6-24 months of age, relying solely on video without written descriptions of behaviors. It has been demonstrated that the VIRSA can detect ASD in infancy when used by parents who already have a child with ASD (Young et al., 2020). This study examined whether the VIRSA would also be useful in a large community sample, when rated by parents without familiarity with ASD.

Objectives: 1) compare VIRSA usage metrics (time to completion, trial duration, etc.) and scores in infancy across two independent prospective samples representing different recruitment strategies, and 2) examine if the VIRSA detects ASD within both samples.

Methods: Parents of infants without a family history of ASD in the Community sample completed the VIRSA online at 6, 9, 12, 18, and 24 months. Any child screening positive on the Modified Checklist for Autism in Toddlers (M-CHAT-R) or the Infant Toddler Checklist (ITC) was seen for a diagnostic evaluation (n = 8 diagnosed with ASD). In the Infant Sibling sample (Young et al., 2020), parents of infants with and without a family history of ASD completed the VIRSA online at similar ages and were also directly assessed from 6 through 36 months (n = 21 with ASD diagnosis).

Results: There were no significant differences found in VIRSA usage metrics between the Community and Infant Sibling samples (Table 1). There were also no group differences in VIRSA scores at most ages (9 months: t = .64; 12 months: t = .34; 18 months: t = -.95; all ps > .05). At 6 months, however, VIRSA scores of the Infant Sibling sample were significantly lower than the Community sample (t = 1.94, p = .05). The VIRSA distinguished ASD, as evidenced by the ASD group having significantly lower scores than the non-ASD group, in both samples (Table 2). VIRSA scores of the ASD subgroup in the Community sample were lower than those in the Infant Sibling sample at most ages, but this was only statistically significant at 9 and 18 months (t = -2.10 and t = 2.08 respectively; both ps < .05).

Conclusions: The VIRSA is operating similarly when used by parents without a family history of ASD as it did in high-risk families (Young et al., 2020), suggesting that similar screening practices can be used in both populations. The ASD subgroup differences found between the Community and Infant Sibling samples are likely driven by random variation in the proportion of infants presenting with early symptoms. In the future, as sample size increases and all participants reach 36 months, we will calculate VIRSA’s psychometric properties (i.e. sensitivity, specificity, positive and negative predictive values).

Authors

• Chandni Parikh, University of California - Davis
  Presenting Author

• Rachel Ni, University of California, Davis
  Non-Presenting Author

• Gregory Young, University of California, Davis
  Non-Presenting Author

• Sally Ozonoff, University of California - Davis
  Non-Presenting Author