Predicting Self-Injurious Behavior at Age Three Among High-Risk Infant Siblings

Poster Presentation
Friday, May 3, 2019: 11:30 AM-1:30 PM
Room: 710 (Palais des congres de Montreal)
A. F. Dimian1, B. Pennington2, K. Botteron3, S. R. Dager4, A. Estes4, H. C. Hazlett5, R. T. Schultz6, J. Piven7, J. Wolff1 and .. The IBIS Network5, (1)University of Minnesota, Minneapolis, MN, (2)University of Minnesota Twin Cities, Minneapolis, MN, (3)Washington University School of Medicine, St. Louis, MO, (4)University of Washington, Seattle, WA, (5)University of North Carolina, Chapel Hill, NC, (6)Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, (7)*Co-Senior Authors, IBIS Network, University of North Carolina, Chapel Hill, NC
Background: Existing research suggests that self-injurious behavior (SIB) is a relatively common behavior disorder that can occur across the lifespan of individuals with autism spectrum disorder (ASD). Repetitive behavior is also a core diagnostic feature of ASD, but few empirical longitudinal studies have examined SIB specifically in the early years of life. We previously reported potential risk factors for SIB using psychosocial variables from 12 months of age to predict SIB at 24 months among a preschool sample of children at high familial risk for ASD (Dimian et al., 2017). In the present study, we extend these findings and examine SIB occurrence and associated potential risk factors at 36 months.

Objectives: 1) Extend our previous models on early potential risk factors with 12 months predictors of SIB occurrence at 24 months to predicting SIB occurrence at 36 months among toddlers at high familial risk for ASD; 2) investigate if sensory experiences and subtypes at 12 months of age predict SIB occurrence at 36 months, and 3) explore how topographies of SIB and stereotypy change across 12, 24 and 36 months of age.

Methods: Participants were from a longitudinal study of infants at familial risk for ASD. The present sample included 149 high-risk infants (65.8% male) who completed the following assessments at ages 12, 24, and 36 months: MSEL, Vineland-II, Sensory Experiences Questionnaire, and Repetitive Behavior Scales-Revised (RBS-R). The RBS-R was used to identify SIB and stereotypy. Descriptive analyses and binary logistic regression models were utilized to examine 12 month predictors for SIB at 36 months.

Results: SIB was reported for 22% of participants at age 36 months and the risk of engaging in SIB was 3.36 times higher among children who received a diagnosis of ASD compared to children with no diagnosis. The first logistic regression model replicated Dimian et al. and included sex, MSEL and Vineland composite scores, and SIB and stereotypy from the RBS-R at 12 months. The overall model significantly predicted 36 month SIB (χ2 = 29.7, p < .001, R2pseudo = 0.29). Of individual predictors, Mullen composite score and stereotypy at 12 months were significantly predictive of SIB at age 36 months. A second model including Sensory subtype scores was evaluated. The overall model was significant (χ2 = 38.9, p < .001, R2pseudo = 0.41). Topographies of SIB and stereotypy changed in overall frequency over time and most children tended to engaged in hitting self against a surface.

Conclusions: SIB was more prevalent among those children who received a diagnosis of ASD. Logistic regression results were mixed but the best fitting model indicated that presence of SIB, stereotypy, hyper and hypo responsivity, and lower intellectual functioning at age 12 months significantly predicted the occurrence of SIB at 36 months. These findings have implications for potential early intervention targets that could help inform prevention programming in the future, but more research is warranted.