Remote Assessments of Motor Skills in Infants at High Familial Risk for ASD

Background: The emergence of foundational motor abilities have implications for the development of several key behaviors during infancy. Specifically, attaining motor milestones, such as reaching, sitting, or walking, provides the child with new learning opportunities about the social and physical world (Gibson, 1988; Libertus & Hauf, 2017). However, in clinical contexts, early motor development is typically neglected unless motor problems are severe enough to interfere with daily living skills. For example, the often noted but mild motor delays observed in Autism Spectrum Disorders (ASD) are not considered diagnostic. This is surprising, given recent reports of delayed postural control and gross motor skills in infants at familial risk for ASD (Flanagan, Landa, Bhat, & Bauman, 2012; Nickel, Thatcher, Keller, Wozniak, & Iverson, 2013). Further, research with typically developing infants has noted far-reaching developmental cascades that are initiated by self-produced motor acts (e.g., Libertus & Needham, 2010, 2011; Soska, Adolph, & Johnson, 2010). Therefore, more research is needed to better understand the emergence of early motor skills and their impact on development across domains as well as their potential role in ASD where subtle differences in motor ability might affect subsequent social-cognitive development.

Objectives: Design and implement a remote observation protocol to study early motor development.

Method: A total of 43 infant-parent dyads provided longitudinal data on grasping and sitting development over an 8-week period starting at 3-months of age. Assessments were conducted in the family’s own home using videoconferencing. On 3 follow-up occasions when the child was 10, 14, and 18-months of age, parents completed language and motor skill questionnaires about their child. Correlation and regression were used to examine the relation among motor skills and with subsequent language development (CDI) at 10 and 14 months.

Results: Results revealed that the emergence of sitting and grasping skills in early infancy do not correlate with each other, suggesting that the child focuses at one skill at a time. Further, only grasping skills seemed impacted by maturational factors. Regression analyses showed that early motor skills did indeed predict language development at 10 and 14 months of age, but not at 18 months of age. However, vocabulary size at both 10 and 14 months were significant predictors of language skills at 18 months. Consequently, early motor skills may indirectly influence language development at 18 months of age.

Conclusions: The current study demonstrates that early motor skills can be assessed remotely via videoconference and provides empirical support for interactions between motor and language development starting in early infancy. Benefits of the remote assessment protocol include its cost efficiency and wide potential participant base. Preliminary observations with infants at high-familial risk for ASD have been started and will be discussed.