Early Identification of Autism: A Prospective Study

描述（由申请人提供）：早期开始强化干预可能会改善自闭症谱系障碍（ASD）儿童的结局;但目前还没有可靠的技术在两岁之前诊断ASD。本研究的目的是确定发生频率的变化，延迟发作，和/或在声乐，运动和沟通技能，可能索引以后ASD诊断的重复性。所采取的方法包括描述这些技能的发展，在婴儿的兄弟姐妹的年龄较大的儿童谁已被诊断为自闭症。婴儿自闭症是已知的ASD和语言延迟的风险增加。我们的目标是前瞻性地区分最终诊断为ASD的婴儿期，最终诊断为语言延迟但不是ASD的婴儿期，以及没有明显并发症的婴儿期。将对150名5至14个月的婴儿进行纵向观察，并在18、24和36个月时进行随访。音频和录像观察旨在对参与者，标准化仪器和父母报告一致的背景下的行为进行采样，将用于研究发声，有节奏的肢体运动，声音运动协调，姿势和运动能力，粗，细，和口腔运动技能，单词和手势。诊断结果将在36个月时使用自闭症诊断观察表、自闭症诊断量表修订版和使用DSM-IV标准的临床判断进行评估。来自所有三个亚组的婴儿SIDAR的数据也将与目前作为单独NAAR和NIH资助研究的一部分进行随访的无已知ASD风险的婴儿的平行数据进行比较。分析将侧重于确定在婴儿期的行为标志物，预测ASD的诊断，评估其阳性预测值，灵敏度和特异性，并评估一组假设的生产模式和发展轨迹的变化，婴儿的声音，运动和沟通行为，可以区分群体和预测最终的ASD或语言延迟诊断。我们目前缺乏可靠的方法来诊断2岁以下儿童的自闭症谱系障碍（ASD）。为了确定以后ASD诊断的可能预测因素，本研究将重点关注ASD特别风险婴儿的发声，运动和沟通技能的发展，并将婴儿发育中的相似性与3岁时的诊断状态联系起来。

DESCRIPTION (provided by applicant): Early initiation of intensive intervention may lead to improved outcomes for children with autism spectrum disorders (ASD); yet there are currently no reliable techniques for diagnosing ASD before the age of two years. This research is designed to identify variations in frequencies of occurrence, delayed onset, and/or atypicalities in vocal, motor, and communicative skills that may index later ASD diagnosis. The approach taken involves describing the development of these skills in infant siblings of older children who have been diagnosed with Autism. Infant Siblings are known to be at elevated risk for ASD and language delay. The goal will be to distinguish prospectively between those Infant Siblings eventually diagnosed with ASD, those eventually diagnosed with Language Delay but not ASD, and those with no apparent atypicalities. One hundred fifty Infant Siblings will be observed longitudinally from ages 5 to 14 months, with follow-up at 18, 24, and 36 months. Audio- and videotaped observations designed to sample behavior in contexts that are consistent across participants, standardized instruments, and parental reports will be employed to study vocalizations, rhythmic limb movements, vocal-motor coordinations, postural and locomotor abilities, gross, fine, and oral-motor skills, words, and gestures. Diagnostic outcomes will be assessed at 36 months with the Autism Diagnostic Observation Schedule, Autism Diagnostic Inventory-Revised, and clinical judgment using DSM-IV criteria. Data from all three subgroups of Infant Siblings will also be compared to parallel data from infants with no known risk for ASD currently being followed as part of separate NAAR and NIH-funded studies. Analyses will focus on identifying behavioral markers in infancy that predict a later diagnosis of ASD, assessing their positive predictive value, sensitivity, and specificity, and on evaluating a set of hypotheses concerning variation in patterns of production and developmental trajectories of infant vocal, motor, and communicative behaviors that may differentiate groups and predict an eventual ASD or Language Delay diagnosis. We currently lack reliable methods for diagnosing autism spectrum disorders (ASD) in children younger than 2 years of age. To identify possible predictors of later ASD diagnosis, this study will focus on the development of vocal, motor, and communicative skills in infants at particular risk for ASD and relate atypicalities in infant development to diagnostic status at 3 years of age.