18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder: A baby siblings research consortium study

Katarzyna Chawarska, Frederick Shic, Suzanne Macari, Daniel J. Campbell, Jessica Brian, Rebecca Landa, Ted Hutman, Charles A. Nelson, Sally J Ozonoff, Helen Tager-Flusberg, Gregory S. Young, Lonnie Zwaigenbaum, Ira L. Cohen, Tony Charman, Daniel S. Messinger, Ami Klin, Scott Johnson, Susan Bryson

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. Although this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated specifically with ASD compared to other developmental outcomes.

Method We applied Classification and Regression Trees (CART) analysis to individual items of the Autism Diagnostic Observation Schedule (ADOS) in 719 HR siblings to identify behavioral features at 18 months that were predictive of diagnostic outcomes (ASD, atypical development, and typical development) at 36 months.

Results Three distinct combinations of features at 18 months were predictive of ASD outcome: poor eye contact combined with lack of communicative gestures and giving; poor eye contact combined with a lack of imaginative play; and lack of giving and presence of repetitive behaviors, but with intact eye contact. These 18-month behavioral profiles predicted ASD versus non-ASD status at 36 months with 82.7% accuracy in an initial test sample and 77.3% accuracy in a validation sample. Clinical features at age 3 years among children with ASD varied as a function of their 18-month symptom profiles. Children with ASD who were misclassified at 18 months were higher functioning, and their autism symptoms increased between 18 and 36 months.

Conclusion These findings suggest the presence of different developmental pathways to ASD in HR siblings. Understanding such pathways will provide clearer targets for neural and genetic research and identification of developmentally specific treatments for ASD.

Original languageEnglish (US)
Pages (from-to)1317-1327.e1
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume53
Issue number12
DOIs
StatePublished - Dec 1 2014

Fingerprint

Siblings
Research
Autistic Disorder
Autism Spectrum Disorder
Genetic Research
Gestures
Appointments and Schedules
Regression Analysis
Observation
Phenotype

Keywords

  • ASD
  • broader autism phenotype
  • high-risk siblings
  • infants
  • predictors of outcomes

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder : A baby siblings research consortium study. / Chawarska, Katarzyna; Shic, Frederick; Macari, Suzanne; Campbell, Daniel J.; Brian, Jessica; Landa, Rebecca; Hutman, Ted; Nelson, Charles A.; Ozonoff, Sally J; Tager-Flusberg, Helen; Young, Gregory S.; Zwaigenbaum, Lonnie; Cohen, Ira L.; Charman, Tony; Messinger, Daniel S.; Klin, Ami; Johnson, Scott; Bryson, Susan.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 53, No. 12, 01.12.2014, p. 1317-1327.e1.

Research output: Contribution to journalArticle

Chawarska, K, Shic, F, Macari, S, Campbell, DJ, Brian, J, Landa, R, Hutman, T, Nelson, CA, Ozonoff, SJ, Tager-Flusberg, H, Young, GS, Zwaigenbaum, L, Cohen, IL, Charman, T, Messinger, DS, Klin, A, Johnson, S & Bryson, S 2014, '18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder: A baby siblings research consortium study', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 53, no. 12, pp. 1317-1327.e1. https://doi.org/10.1016/j.jaac.2014.09.015
Chawarska, Katarzyna ; Shic, Frederick ; Macari, Suzanne ; Campbell, Daniel J. ; Brian, Jessica ; Landa, Rebecca ; Hutman, Ted ; Nelson, Charles A. ; Ozonoff, Sally J ; Tager-Flusberg, Helen ; Young, Gregory S. ; Zwaigenbaum, Lonnie ; Cohen, Ira L. ; Charman, Tony ; Messinger, Daniel S. ; Klin, Ami ; Johnson, Scott ; Bryson, Susan. / 18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder : A baby siblings research consortium study. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2014 ; Vol. 53, No. 12. pp. 1317-1327.e1.
@article{8adff650ef6b4a5195eccaf536312295,
title = "18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder: A baby siblings research consortium study",
abstract = "Objective Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. Although this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated specifically with ASD compared to other developmental outcomes.Method We applied Classification and Regression Trees (CART) analysis to individual items of the Autism Diagnostic Observation Schedule (ADOS) in 719 HR siblings to identify behavioral features at 18 months that were predictive of diagnostic outcomes (ASD, atypical development, and typical development) at 36 months.Results Three distinct combinations of features at 18 months were predictive of ASD outcome: poor eye contact combined with lack of communicative gestures and giving; poor eye contact combined with a lack of imaginative play; and lack of giving and presence of repetitive behaviors, but with intact eye contact. These 18-month behavioral profiles predicted ASD versus non-ASD status at 36 months with 82.7{\%} accuracy in an initial test sample and 77.3{\%} accuracy in a validation sample. Clinical features at age 3 years among children with ASD varied as a function of their 18-month symptom profiles. Children with ASD who were misclassified at 18 months were higher functioning, and their autism symptoms increased between 18 and 36 months.Conclusion These findings suggest the presence of different developmental pathways to ASD in HR siblings. Understanding such pathways will provide clearer targets for neural and genetic research and identification of developmentally specific treatments for ASD.",
keywords = "ASD, broader autism phenotype, high-risk siblings, infants, predictors of outcomes",
author = "Katarzyna Chawarska and Frederick Shic and Suzanne Macari and Campbell, {Daniel J.} and Jessica Brian and Rebecca Landa and Ted Hutman and Nelson, {Charles A.} and Ozonoff, {Sally J} and Helen Tager-Flusberg and Young, {Gregory S.} and Lonnie Zwaigenbaum and Cohen, {Ira L.} and Tony Charman and Messinger, {Daniel S.} and Ami Klin and Scott Johnson and Susan Bryson",
year = "2014",
month = "12",
day = "1",
doi = "10.1016/j.jaac.2014.09.015",
language = "English (US)",
volume = "53",
pages = "1317--1327.e1",
journal = "Journal of the American Academy of Child and Adolescent Psychiatry",
issn = "0890-8567",
publisher = "Elsevier Limited",
number = "12",

}

TY - JOUR

T1 - 18-month predictors of later outcomes in Younger siblings of children with autism spectrum disorder

T2 - A baby siblings research consortium study

AU - Chawarska, Katarzyna

AU - Shic, Frederick

AU - Macari, Suzanne

AU - Campbell, Daniel J.

AU - Brian, Jessica

AU - Landa, Rebecca

AU - Hutman, Ted

AU - Nelson, Charles A.

AU - Ozonoff, Sally J

AU - Tager-Flusberg, Helen

AU - Young, Gregory S.

AU - Zwaigenbaum, Lonnie

AU - Cohen, Ira L.

AU - Charman, Tony

AU - Messinger, Daniel S.

AU - Klin, Ami

AU - Johnson, Scott

AU - Bryson, Susan

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Objective Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. Although this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated specifically with ASD compared to other developmental outcomes.Method We applied Classification and Regression Trees (CART) analysis to individual items of the Autism Diagnostic Observation Schedule (ADOS) in 719 HR siblings to identify behavioral features at 18 months that were predictive of diagnostic outcomes (ASD, atypical development, and typical development) at 36 months.Results Three distinct combinations of features at 18 months were predictive of ASD outcome: poor eye contact combined with lack of communicative gestures and giving; poor eye contact combined with a lack of imaginative play; and lack of giving and presence of repetitive behaviors, but with intact eye contact. These 18-month behavioral profiles predicted ASD versus non-ASD status at 36 months with 82.7% accuracy in an initial test sample and 77.3% accuracy in a validation sample. Clinical features at age 3 years among children with ASD varied as a function of their 18-month symptom profiles. Children with ASD who were misclassified at 18 months were higher functioning, and their autism symptoms increased between 18 and 36 months.Conclusion These findings suggest the presence of different developmental pathways to ASD in HR siblings. Understanding such pathways will provide clearer targets for neural and genetic research and identification of developmentally specific treatments for ASD.

AB - Objective Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. Although this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated specifically with ASD compared to other developmental outcomes.Method We applied Classification and Regression Trees (CART) analysis to individual items of the Autism Diagnostic Observation Schedule (ADOS) in 719 HR siblings to identify behavioral features at 18 months that were predictive of diagnostic outcomes (ASD, atypical development, and typical development) at 36 months.Results Three distinct combinations of features at 18 months were predictive of ASD outcome: poor eye contact combined with lack of communicative gestures and giving; poor eye contact combined with a lack of imaginative play; and lack of giving and presence of repetitive behaviors, but with intact eye contact. These 18-month behavioral profiles predicted ASD versus non-ASD status at 36 months with 82.7% accuracy in an initial test sample and 77.3% accuracy in a validation sample. Clinical features at age 3 years among children with ASD varied as a function of their 18-month symptom profiles. Children with ASD who were misclassified at 18 months were higher functioning, and their autism symptoms increased between 18 and 36 months.Conclusion These findings suggest the presence of different developmental pathways to ASD in HR siblings. Understanding such pathways will provide clearer targets for neural and genetic research and identification of developmentally specific treatments for ASD.

KW - ASD

KW - broader autism phenotype

KW - high-risk siblings

KW - infants

KW - predictors of outcomes

UR - http://www.scopus.com/inward/record.url?scp=84912092771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84912092771&partnerID=8YFLogxK

U2 - 10.1016/j.jaac.2014.09.015

DO - 10.1016/j.jaac.2014.09.015

M3 - Article

C2 - 25457930

AN - SCOPUS:84912092771

VL - 53

SP - 1317-1327.e1

JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

SN - 0890-8567

IS - 12

ER -