Abstract
Cognitive and adaptive behaviour abilities early in life provide important clinical prognostic information. We examined stability of such skills in children at high familial risk for ASD who either met diagnostic criteria for ASD at age 7 years (HR-ASD, n = 15) or did not (HR-non-ASD, n = 24) and low-risk control children (LR, n = 37), prospectively studied from infancy. For both HR groups, cognitive skills were consistently lower across time than those of LR children. HR-ASD children showed increasing difficulties in adaptive behaviour over time compared to LR children, while the HR-non-ASD children showed no such difficulties. This pattern of change may inform our understanding of developmental profiles of HR siblings beyond core ASD symptoms.
Highlights
The diagnostic criteria for autism spectrum disorder (ASD) in DSM-5 (APA 2013) introduce the notion that symptomatology “may not become fully manifest until social demands exceed limited capacities” or, that it “may be masked by learned strategies in later life”
We hypothesised that the gap between HR-ASD children and both low risk (LR) and HR-non-ASD children would widen with time for adaptive skills but not for cognitive skills
We found that the gap between LR children and both HR groups remained stable over time for cognitive skills but widened progressively over time for adaptive behaviour
Summary
The diagnostic criteria for autism spectrum disorder (ASD) in DSM-5 (APA 2013) introduce the notion that symptomatology “may not become fully manifest until social demands exceed limited capacities” or, that it “may be masked by learned strategies in later life”. This novel approach stresses the importance of assessing the person/environment relationship, which can vary over time and across individuals, when evaluating the presence and impact of core symptoms of ASD. Ozonoff et al (2014) found different developmental trajectories, with the LR typically developing children sharply increasing on all scales with age, a slower growth on verbal scales for the HR typically developing children, significantly lower rate of change for ASD children, and an intermediate performance for the atypically developing HR-non-ASD children with a slower rate of growth that amplified from 12 to 36 months
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