Attentional Domains of Parent-Reported Infant Behaviors: Implications and Relations to Social Responsiveness and Risk for Autism

Background: Numerous studies have documented the strong relationship between a child’s early attentional skills and a later diagnosis of autism, especially for behaviors of initiating (IJA) and responding to joint attention (RJA), and overfocused attention (OFA). These relations are especially relevant considering the attention network model and associated brain regions (Posner & Peterson, 1989), with significant research associating aberrant activity or connectivity among networks associated with attention in individuals with autism (e.g., Mundy & Newell, 2007). Many behavioral and neurological deficits can be observed in children at risk for autism during infancy. Baranek and colleagues (2003) developed the First Year Inventory (FYI) to flag 12-month-olds at risk for a diagnosis of autism.  Although this measure has accurately identified children who receive a diagnosis of autism or other developmental disorder (Turner-Brown et al., 2012), there may be value in exploring additional ways of scoring the FYI that could be associated with later cognitive deficits associated with autism. 

Objectives: The objective of this study was to explore FYI items that may be specific to constructs of attention that could be useful as identifiers of eventual risk of autism, and then to look at associations between these new constructs and the children’s later scores on the Social Responsiveness Scale – Preschool version (Pine et al., 2006).

Methods: Through a comprehensive review of the literature on typical and atypical infant attention development, and considerations of statistical and theoretical validity, we operationalized three new constructs of attention from the FYI items: IJA, RJA and OFA. An extant database with FYIs (N=7823) was analyzed using the new constructs to determine strength of relations among items. For this study, the new domains were applied to data obtained from parents of 12-month-olds in the original FYI cohort (N=1305; Reznick et al., 2007). Regression analyses were used to measure association of the new constructs to later measures of autism severity (SRS-P) at age 3 for a subset of 699 cases (Turner-Brown et al., 2012).

Results: Cronbach’s alpha analysis indicated good internal consistency (0.763, 0.723, and 0.699 for IJA, RJA & OFA, respectively). Preliminary data analyses showed statistically significant relations between the scores on these domains at 12 months and SRS-P scores at age three (R²=.15; p< 0.01 for all three variables). 

Conclusions: Scores on three new attention-based constructs developed from the FYI items at 12 months of age were found to be significantly related to SRS-P scores at 3 years of age and support the notion that early attention skills may be associated with symptoms of autism. Scores on these three constructs may allow for the establishment of profiles of attention that could be used in longitudinal studies to better understand developmental trajectories for children at risk for ASD.