19290
Parent Prediction of ASD in Infants at Risk

Thursday, May 14, 2015: 5:30 PM-7:00 PM
Imperial Ballroom (Grand America Hotel)
C. Wang1, M. Feldman2, R. A. Ward3, M. L. Hudson4 and X. Liu5, (1)Centre for Applied Disability Studies, Brock University, New Westminster, BC, Canada, (2)Centre for Applied Disability Studies, Brock University, St. Catharines, ON, Canada, (3)Applied Disability Studies, Brock University, St. Catharines, ON, Canada, (4)Psychiatry, Queen's University, Kingston, ON, Canada, (5)Psychiatry, Queen’s University, Kingston, ON, Canada
Background: Infants with older siblings with ASD are at biological risk for ASD or the broader phenotype.  Early identification could lead to earlier treatment and prevention.

Objectives:  This study compared three groups of 1 to 36 month children (N = 108) at-risk (because they had an older biological sibling with ASD) on the Parent Observation of Early Markers Scale (POEMS, Feldman et al., 2012). The POEMS has 61 items completed prospectively by parents. Parents rate each item as 1 (no problem) to 4 (severe problem) with ½ scores allowed; scores range from 61-244. Elevated items are those with scores of 3, 3.5 or 4. 

Methods:   The groups were: (1) 13 children who were eventually diagnosed with ASD by 13 years; (2) 5 children who lost their ASD diagnosis by 6 years; and (3) 89 children never diagnosed.  A mixed ANOVA determined the differences between the three groups on the POEMS total scores and elevated items. 

Results: Using all available POEMS scores at 9, 12, 18, 24 and 36 months, total POEMS scores differed between groups, F(2, 69) = 11.78, p <  .001, partial eta-squared (h2) = .025, and group X age was significant, F(8, 276) = 3.76, p <  .001, (h2) = .098. Post hoc comparisons using the Tukey HSD test showed that the diagnosed group (M = 87.76, SD = 28.68) had significantly higher scores than the undiagnosed group (M = 67.83, SD = 8.33). The lost diagnosis group (M = 74.70, SD = 8.63) did not differ significantly from the diagnosed and undiagnosed groups. The groups differed on the number of elevated items, F (2, 70) = 9.34, p <  .001, h2  = .21, and group X age was significant, F (8, 280) = 3.16, p <  .001, (h2) = .083. Post hoc comparisons using the Tukey HSD test showed that the diagnosed group (M = 7.3 SD = 9.78) had significantly more elevated items than the undiagnosed group (M = 1.10, SD = 2.34), but not the lost diagnosis group (M = 1.93, SD = 1.64) that also did not differ from the undiagnosed group. (3) Repeated measures analyses revealed a significant age effect as the children got older on total POEMS scores F (4, 276) = 4.55, p <  .001, h2  = .062, but not for elevated items F (4, 280) = 2.28, p =  .061, h2 = .032. Significant differences in total scores and elevated items between the undiagnosed and diagnosed groups began emerging as early as 12 months.  Across ages, imitation, verbal communication, pointing in response to a question, tolerance for waiting and acceptance of food most differentiated the at risk infants eventually diagnosed from those who had not been diagnosed by age 13 years.  

Conclusions:  The findings suggest that by completing the POEMS prospectively, parents of at-risk infants may be able to predict which infants will or not be diagnosed, or lose their ASD diagnosis, as early as 12 months of age, with prediction increasing the closer the child is to 36 months.

See more of: Early Development (<48 months)
See more of: Early Development (< 48 months)