ASD and Development

Patricia Rakovic

• Differences in language development in the child with autism spectrum disorder (ASD)a. Joint attention

• b. Verbal development• c. Non-verbal language development• d. Theory of mind• e. Pro-social communication• f. Conversational skills• g. Early differences in development in a child with ASD• h. Differences in brain development• i. Dyspraxia• j. Theory of mind difficulties• k. How the combination of verbal, non-verbal communication and

motor planning difficulties impacts social communication.• How to take a language sample

Autism Spectrum Disorders• Problems with socialization• Problems with

communication• Unusual behaviors

• It’s more than height and weight• Observing how children play, learn, speak

and act• Different areas of development

– Social, communication, cognitive, gross motor, fine motor, adaptive

• Monitoring milestones can offer early signs of delay including signs of autism spectrum disorders

Child Development

• Accurate diagnosis of autism required significant knowledge of typical development in the following areas: social, communication, cognitive skills, and play skills.

• Understanding developmental profiles: must know what is typical for development and atypical for development at any age.

Autism is a Developmental Disorder

Methodological Approaches to Studying Emergence of Autism

• Retrospective studies of affected children – Parental report– Video diaries analysis

• Prospective studies of infant siblings at risk for ASD– Recurrence risk for autism: 5-10%– High risk for other developmental

problems:• Language or cognitive delays• Broader Autism Phenotype, BAP

Potential Areas of Dysfunction in the 1st Year

1. Typical Development– 0 to 3 months:

• Sensitivity to and preference for face-like stimuli and speech-like sound

– 3 to 6 months: • Emergence of dyadic social interactions

– 6 to 9 months: • Development of face processing skills (identity, affect, gender)• Response to name• Anticipatory social games

– 9 to 12 months: • Social monitoring and imitation• Social referencing• Joint attention

2. Many skills affected in toddlers with ASD emerge typically in the first year

Patterns of Onset

• Early onset (1st year): – “Inborn autistic disturbances of affective

contact” (Kanner, 1943)

• Later onset (2nd year):– Regression (15-27% of cases) (Eisenberg &

Kanner, 1955; Dawson et al., 2006; Landa et al., 2007)

– Plateau (Ozonoff et al., 2008; Hansen et al., 2008)

Age of Onset: Parental Perception

• Average age at first concern: – 15 months

(SD=6.5)

• Primary concerns: – Social difficulties– Speech delays

• Why such a variability?

0

5

10

15

20

25

0-2 3-4 5-6 7-8 9-10 11-12 13-14 15-16 17-18 19-20 21-22 23-24

Age (monhts)

Perc

ent

Chawarska, Paul, Klin et al., 2007, JADD.

Recent study by CDC indicated most children with an ASD diagnosis had signs of a developmental problem before the age of 3, but average age of diagnosis was 5 years.

Parental Concerns (Wiggins, Baio, Rice, 2006)

Early Development• Babies start communicating

and relating to other people at birth

• Continued social-emotional development is key to forming strong relationships and continued learning