Understanding at-Risk Infants: Heterogeneity in Child and Parental Characteristics in a Sample Referred to Early Intervention Research

Poster Presentation
Friday, May 11, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
A. Gulsrud1, J. R. Williams2, L. Hughart3, N. Tu4, A. M. Herrera5 and C. Kasari3, (1)UCLA Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, (2)Biostatistics, UCLA, Los Angeles, CA, (3)University of California, Los Angeles, Los Angeles, CA, (4)UCLA Semel Institute, Los Angeles, CA, (5)Semel Institute, UCLA, Los Angeles, CA
Background: Autism Spectrum Disorder (ASD) can be reliably diagnosed in children as young as two years of age, but behavioral signs of autism can be detected in children as young as 12 months of age. Growing awareness of the disorder and its earliest signs has led to an increased number of referrals for intervention in younger and younger populations and a need to better understand heterogeneity in child and parent factors at the outset of treatment.

Objectives: The goal of this study is to characterize a sample of young children at-risk for ASD referred for an early intervention study by 1) establishing subgroups of children defined by sibling status, 2) exploring the relationship between these established subgroups and measures of social-communication, RRBs, cognitive and language functioning and parental stress, and 3) examining how levels of autism symptomatology relate to parental stress by subgroup.

Methods: A total of 105 at-risk toddlers, 12 to 22 months old, were referred and screened for entry into a clinical trial. 80 of these at-risk toddlers qualified for entry into the trial by scoring with at least mild to moderate concern on the ADOS Toddler module. This population was broken down into three groups: toddlers with no siblings (41%), toddlers with siblings without autism (29%), and toddlers with at least one sibling with autism (30%). These subgroups will be referred to as: No Siblings, No Siblings with ASD, and Infant Siblings, respectively. There was no significant difference in rate of qualification into the study based on sibling status,, p=0.40, although fewer children who were Infant Siblings qualified compared to No Siblings with ASD and No Siblings (71% vs. 85% and 75%). The children were predominately male (81%) and White (47%) with an average age of 17.68 months and standard deviation of 3.10 months.

Results: On average, Infant Siblings presented with lower average levels of restricted and repetitive behaviors compared to No Siblings and No Siblings with ASD (2.46 vs. 2.70 and 3.65; F(2,77) = 4.42, p = 0.02). Infant Siblings also had statistically higher average expressive language age equivalence (12.23 months) compared to No Siblings (10.28 months) and No Siblings with ASD (8.48 months; F(2,72) = 4.33, p = 0.02). Conversely, parents of Infant Siblings reported statistically higher levels of stress on a parental daily hassle questionnaire (52%) compared to parents of No Sibling children (39%) and parents of No Sibling with ASD children (44%; F (2,49) = 3.37, p= 0.04). A positive correlation between ASD symptomatology and parental stress existed for the Infant Sibling group (r=0.28), but no other subgroup showed this association.

Conclusions: This study provides preliminary evidence for child and parent differences in subgroups of young children referred to an early intervention study. Prior to entering into treatment, Infant siblings displayed less RRBs and higher expressive language, yet still had parents with the highest levels of reported stress. Understanding variability in symptom profile and familial factors at the outset of treatment has the potential to assist in determining more tailored intervention approaches.