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Early Social Skill Developmental Trajectories and Developmental Differences across the Social Spectrum
Autism Spectrum Disorder (ASD) is characterized by deficits in social communication and interactions; these deficits are often first identified when children fail to reach certain developmental milestones. Yet milestone achievement varies across individuals, and little is known about the developmental progression of specific social skills within either typical development or ASD. Furthermore, social functioning is not binary; rather social functioning exists along a full spectrum (Social Spectrum; Dowd et al., 2018) from typical development to clinical severe impairment. Research is needed to identify the early developmental trajectories of crucial social skills and how this development varies across the Social Spectrum.
Objectives:
Evaluate the progression of four social skills (Response to Name; Sharing Interests; Showing/Pointing; Coordinating Eye Contact with Nonverbal Communication) from 9 to 24 months and identify the extent to which development varies across the Social Spectrum.
Methods:
High-risk (N=111) and low-risk (N=131) infants were assessed at 9, 12, and 18 months. The Systematic Observation of Red Flags of Autism Spectrum Disorder (Wetherby et al., 2016) is an observational screening measure that detects red flags of ASD based on a communication assessment. Four items were identified and reversed scored (0-3) to assess for positive social skill development. These items had corresponding items on the Autism Diagnostic Observation Schedule–Toddler Module (Luyster et al., 2009), administered at 24 months. Of note, there were differences in the coding of items across measures; therefore, data was analyzed both with and without the inclusion of the 24-month data. The Early Screening for Autism and Communication Disorders (Wetherby, Woods, & Lord, 2012) is a parent measure that ranks infant skills as Not Yet/Rarely, Sometimes, or Often occurring for 22 items related to Social Interacting and Communicating. For this project, the sum of items was used as a measure of Social Spectrum at 9 months. Linear mixed-effects models were conducted separately for each skill, with Age, Social Spectrum, and their two-way interaction as predictors. Non-significant interactions and main effects were removed to yield optimal models.
Results:
See table for preliminary results with limited 24-month data (N=137); remaining data will be included by April 2019. There were significant main effects of Age and Social Spectrum, with and without the 24-month data, on Sharing Interests, Showing/Pointing, and Coordinating Eye Contact with Nonverbal Communication. For Response to Name, there was a significant interaction of Age and Social Spectrum utilizing the 9- to 18-month data, yet there was only a significant main effect of Age with the 24-month data included.
Conclusions:
These crucial social skills are developing between 9-24 months. Additionally, higher social functioning at 9 months is related to better social initiation skills across 9-24 months. While Response to Name improves over time, this development varies based on infants’ social functioning at 9 months. Identifying the developmental trajectories of crucial early social skills, particularly deviations in development across the Social Spectrum, may inform our understanding of the developmental model of ASD and help establish timeframes and target areas for early invention for children with varying degrees of social impairment.