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Gepubliceerd in: Journal of Autism and Developmental Disorders 7/2015

01-07-2015 | Original Paper

The Development of Coordinated Communication in Infants at Heightened Risk for Autism Spectrum Disorder

Auteurs: Meaghan V. Parladé, Jana M. Iverson

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 7/2015

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Abstract

This study evaluated the extent to which developmental change in coordination of social communication in early infancy differentiates children eventually diagnosed with ASD from those not likely to develop the disorder. A prospective longitudinal design was used to compare nine infants at heightened risk for ASD (HR) later diagnosed with ASD, to 13 HR infants with language delay, 28 HR infants with no diagnosis, and 30 low risk infants. Hierarchical linear modeling analyses revealed that ASD infants exhibited significantly slower growth in coordinations overall and in gestures coordinated with vocalizations, even relative to HR infants with language delay. Disruption in the development of gesture–vocalization coordinations may result in negative cascading effects that adversely impact later social and linguistic development.
Voetnoten
1
The exception was for one HR-ASD infant who met clinical best estimate criteria for ASD at 36 months but his 36-month ADOS scores fell below the cutoff for ASD by one point (Severity score = 3, Cut-off ≥ 4). He was retained in the ASD category due to clinically significant ADOS scores and clinical best estimate at 24 months. 36-month ADOS scores for two additional HR infants were deemed invalid due to shyness and/or noncompliance; one child was classified as HR-ND and one as HR-LD.
 
2
Two HR-ND infants demonstrated nonspecific developmental delays (“other delay”) as indicated by MSEL standard scores at or below 1.5 SD from the mean on one or more non-language subscales (e.g., Fine Motor) and/or elevated scores (albeit below clinical cut-off) on the ADOS-G. Neither of these infants’ parents reported concern, nor did they receive early intervention services. Further, visual inspection of the data suggested that communicative patterns for HR-ND “other delay” infants were not substantially different from other HR-ND infants; thus, the decision was made to retain them in this category.
 
3
Elicited behaviors were those in which (a) the child was given explicit instructions that involve a specific directive (e.g., caregiver says “give me the ball” and child picks up the ball and hands it to her; caregiver says “Say ball” and child says “ball”), or (b) the child’s behavior was directly prompted by physical movement or touching by the communicative partner (e.g., the caregiver tickles the child and the child smiles and laughs).
 
4
There were 6 missing sessions at 8 months (all HR); 2 missing sessions at 10 months (both HR); 3 missing sessions at 12 months (2 HR, 1 LR); 1 missing session at 14 months (HR); and 1 missing session at 18 months (LR).
 
5
Nested, hierarchical data violate assumptions of independence required in traditional regression analyses. Violating assumptions of independence can result in downwardly biased (smaller) standard errors and alpha inflation. Thus, failure to account for nested and hierarchical levels can result in more frequent, incorrect, rejections of the null hypothesis and false positive results.
 
6
Differences remained even after controlling for overall communicativeness. Further, variables of interest were calculated as proportion of total communicative acts and raw data was plotted. Visual inspection of the data suggested that proportion variables followed the same developmental patterns (in terms of both overall developmental pattern and group differences in trajectories) as those calculated as rates.
 
7
Results were identical when assessing for group differences in Gesture + NWV combinations alone. Gesture + Word combinations were not analyzed separately due to their low frequency.
 
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Metagegevens
Titel
The Development of Coordinated Communication in Infants at Heightened Risk for Autism Spectrum Disorder
Auteurs
Meaghan V. Parladé
Jana M. Iverson
Publicatiedatum
01-07-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 7/2015
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-015-2391-z