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Cascading Effects of Attention Disengagement and Sensory Seeking on Social Symptoms in a Community Sample of Infants at-Risk for a Future Diagnosis of ASD

Saturday, May 13, 2017: 12:00 PM-1:40 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
G. T. Baranek1, T. Woynaroski2, S. Nowell1, L. Turner-Brown3, M. DuBay1, E. Crais4 and L. R. Watson5, (1)University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)Hearing and Speech Sciences, Vanderbilt University Medical Center, Thompsons Stn, TN, (3)UNC TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, (4)Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, (5)University of North Carolina- Chapel Hill, Chapel Hill, NC
Background: Sensory seeking behaviors are prevalent across development in children with ASD and are associated with greater autism severity and lower social adaptive skills (Ausderau et al., 2016; Watson et al., 2010). These features are also correlated with attention disengagement difficulties (Sabatos-Devito et al., 2016). Preliminary work with infants at familial risk for ASD (i.e., infants sibs) suggests that sensory seeking may predict later social symptomatology, mediated through reduced social orienting (Woynaroski et al., under review).

Objectives: We aimed to systematically replicate and extend earlier findings, drawing on extant longitudinal data from a community sample of one year-olds at-risk for a later diagnosis of ASD.

Our specific research questions were (1) Is increased sensory seeking late in the second year of life (i.e., 20-24 months) related to social symptom severity at 3-5 years of age, via social orienting? (2) Is increased sensory seeking as measured earlier in the second year of life (i.e., 13-15 months) similarly predictive and mediated by social orienting?

Methods: 55 infants were identified at 12 months of age using the two-domain cut-off on the First Year Inventory (Turner-Brown et al., 2013) as part of recruitment into an intervention study, and assessed at three time points (T1: 13-15 mos.; T2: 20-24 mos.; T3: 3-5 yrs.). Intervention and control groups were merged for these analyses since no main effects of treatment on child outcomes were found in the parent study. Two mediation models were conducted testing the extent to which observed sensory seeking behavior, tested at T1 & T2 using the Sensory Processing Assessment (SPA; Baranek, 1999), predicted ADOS social-affective calibrated severity scores (T3), mediated through social orienting, which was also measured using the SPA (T2). Post-hoc analyses investigated attention disengagement as a precursor of seeking behaviors in early development.

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Results: We replicated findings that a) high-risk children who go on to be diagnosed with ASD show heightened sensory seeking in the 2nd year of life relative to those who do not receive a diagnosis, and b) increased sensory seeking indirectly related to later social symptomatology via reduced social orienting. Sensory seeking appears to have more clinical utility later in the second year of life (20-24 mos.) than earlier (13-15 mos.) in the present sample. Post hoc analyses suggested diminished attention disengagement at 12-15 mos. preceded and predicted increased sensory seeking at 20-24 mos.

Conclusions:  Findings added support for the notion that sensory features produce cascading effects on social development in infants at risk for ASD and suggest that reduced attention disengagement early in life may set off this cascade.