Correspondance Between Maternal Concerns and Concurrent Infant Behavior in 12-Month-Old Infants At Risk for Autism

Background:  Data on the early development of autism spectrum disorders (ASD) primarily comes from two lines of research – prospective investigations monitoring the development of infants at risk for autism, and retrospective investigations of behavior based on parent interviews or coding of family home videos. Recent work on parent report measures suggests poor correspondence between retrospective reports of early infant behavior and observational measures of these same infants’ scored from home video (Ozonoff et al., 2011). However, the relationship between parents’ report of developmental concerns and infants’ current behaviors has not been systematically studied. Understanding the relationships between these concurrent measures will be important for both characterizing the early behavioral phenotype as well as improved screening and early diagnosis.

Objectives: The goal of this investigation is to examine parents’ report of developmental concerns and the relationship between these reported concerns and infants’ concurrent behaviors.

Methods: As part of their participation in an ongoing longitudinal study of infants as risk for autism, families were asked to complete short weekly diaries about infants’ language and gesture acquisition, social play behaviors, and any developmental concerns on the part of the parent. Infants are considered low risk if there is no family history of autism (LRC) and high risk if at least one older sibling has a diagnosis. The present analysis included 40 families (25 HRA, 16 LRC), and focused on the 8-week period surrounding infants’ first birthdays. Parental concerns were scored across several domains including both illness-related (flu, teething, fever, etc.) and ASD-relevant (language, social, temperament, repetitive behaviors, etc) concerns. A total score for each domain was calculated as the average number of concerns reported during this 8-week period. Infants were seen in the laboratory at 12 months of age, where they were administered the Mullen Scales of Early Learning (MSEL) and the Autism Diagnostic Observation Scale for Infants (AOSI).  Verbal and Non-Verbal Developmental Quotients (VDQ and NVDQ) were calculated from MSEL scores, and infants’ AOSI total scores were used as an index of ASD symptoms.

Results: HRA mothers reported significantly more ASD-relevant concerns than the LRC mothers (t (27) = 3.47, p < .01). There were no group differences in the number of illness-related concerns. HRA infants had significantly lower VDQ, but not NVDQ scores than the LRC infants. For HRA infants, maternal ASD-relevant concerns were significantly negatively correlated with infants’ VDQ scores, but not AOSI total scores (VDQ: r = -.50, p <.05; AOSI: r = .24, p =.26).

Conclusions: The HRA mothers in this sample reported significantly more ASD-relevant concerns around infants’ first birthdays than a group of age-matched control mothers. While these concerns were correlated with infants’ concurrent language level, they were not correlated with infants’ ASD symptoms. These results suggest that HRA mothers may be better at recognizing and reporting more concrete language-related ‘red flags’ such as lack of babbling or responding to name than more global measures of social engagement. The implications of these findings will be discussed.