Do Social Communication Deficits During Infancy Project Later Language Abilities in Infants who Develop Autism?

• In Event: Socio-cognitive abilities in children with Autism Spectrum Disorder

Abstract

Background: Social communication deficits often emerge around the first birthday in infants who go on to have autism (Landa et al., 2007; Ozonoff et al., 2010; Zwaigenbaum et al., 2005). Wetherby et al. (2007) reported that social communication abilities measured in the second year of life predict later verbal and nonverbal development. Hence, early social communication skills are a harbinger for later development and measuring these skills during infancy will elucidate risk markers and treatment targets for infants who develop autism. Objectives: The objectives of this study were to examine group differences in social communication skills and to evaluate their relationship to later language abilities. Methods: Infant participants (N=467) were part of the Infant Brain Imaging Study (IBIS).The Communication and Symbolic Behavior Scales (CSBS; Wetherby & Prizant, 2002) was administered at 12 and 24 months to measure social communication skills across three groups: low familial risk typically developing infants (LR-Neg; n=140), high familial risk infants without autism (HR-Neg; n=252), and high familial risk infants with autism (HR-ASD; n=75). HR-ASD infants met clinical best-estimate criteria for autism using the DSM-IV-TR, and HR- Neg infants did not. LR-Neg infants did not meet criteria for autism or language delay (Table 1). Analyses focused on CSBS total, social composite, speech composite, and symbolic composite raw scores to avoid floor effects in standard scores. The longitudinal statistical model included the effects of group, time (chronological age), group*time. The Mullen Scale of Early Learning (MSEL; Mullen, 1995) was used to evaluate language skills at 24 months. For the statistical model analyzing the effects of 12-month social communication scores on later language skills, receptive and expressive language age equivalent scores were dependent variables. The analyses included social communication scores, group, and social communication scores*group. Sex of the infant and maternal education were included in all models a covariates.Results: Longitudinal analyses using general linear models indicated significant main effects for time (p<.001), and group*time (p<.001) for all CSBS scores (Table 1). The main effect of group was significant for social (p<.001) and symbolic (p=.001) scores. HR-ASD infants had fewer gains in social communication from 12-24 months (Figure 1) and had lower CSBS total scores at 12 and 24 months (Table 1) when compared to HR-Neg and LR-Neg infants. Results from the language analyses revealed significant main effects for all CSBS scores (p<.001). The CSBS total scores *group effect was significant for expressive language (p=.03). Follow-up group analyses indicated that the effect of CSBS total scores was significant for the HR-Neg (p<.001) and LR-Neg infants (p<.001), but not significant for the HR-ASD infants.Conclusions: Results indicate that HR-ASD infants demonstrate difficulties with social communication as early as 12 months of age, well before autism diagnoses are considered stable. Infants who developed autism did not demonstrate the same association between early social communication and later language that was seen in typically developing infants. These findings have implications for identifying early intervention treatment targets that will impact later language.

Group Authors

IBIS network (Infant Brain Imaging Study)

Authors

• Shruthi Ravi, University of Texas at Dallas
  Presenting Author

• Julia Parish-Morris
  Non-Presenting Author

• Lisa Yankowitz, University of Pennsylvania
  Non-Presenting Author

• Sarah Paterson, James S McDonnell Foundation
  Non-Presenting Author

• Annette Mercer Estes, Uniiversity of Washington
  Non-Presenting Author

• Heather Cody Hazlett, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Juhi Pandey, Children's Hospital of Philadelphia
  Non-Presenting Author

• Shoba S Meera, National Institute of Mental Health and Neurosciences
  Non-Presenting Author

• Lonnie Zwaigenbaum, University of Alberta
  Non-Presenting Author

• Kelly Botteron, Washington University in St. Louis
  Non-Presenting Author

• Stephen Dager, University Of Washington
  Non-Presenting Author

• Robert Schultz, Children's Hospital of Philadelphia
  Non-Presenting Author

• Catherine Burrows, University of Minnesota - Twin Cities
  Non-Presenting Author

• Chad Chappell, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Tanya St. John, University of Washington
  Non-Presenting Author

• Meghan Swanson, University of Texas at Dallas
  Non-Presenting Author

• Joseph Piven, University of North Carolina at Chapel Hill
  Non-Presenting Author