Assessment & Research

ASSESSMENT OF DISTRESS IN YOUNG CHILDREN: A COMPARISON OF AUTISTIC DISORDER, DEVELOPMENTAL DELAY, AND TYPICAL DEVELOPMENT.

Esposito et al. (2011) · Research in autism spectrum disorders 2011
★ The Verdict

A toddler whose cry sounds unusually high or tense is more likely to later be diagnosed with autism.

✓ Read this if BCBAs who screen or train staff in early-intervention clinics.
✗ Skip if Clinicians working only with verbal school-age clients.

01Research in Context

01

What this study did

Researchers played 18-month-old cry sounds to adults. The cries came from three groups: kids later diagnosed with autism, kids with developmental delay, and typically developing kids. Adults rated how upset and how "odd" each cry sounded.

02

What they found

Cries from the autism group were judged more distressed and stranger-sounding. The biggest gap was in voice pitch and tone, not in facial or body cues.

03

How this fits with other research

Esposito et al. (2014) got the same result using the Strange Situation test. Their high-risk toddlers who later got an ASD label also made shorter, higher-pitched cries.

Spates et al. (2013) looked deeper into the ear. They found autistic toddlers had slower brain-stem reflexes to sound. Together the papers show both the cry that comes out and the brain response that goes in are off.

Mulder et al. (2020) add a twist: babies who later get diagnosed often seem "easy" at first. So early quietness can fool you, but odd-sounding cries are a clearer red flag.

04

Why it matters

You can’t give every toddler a brain-stem test, but you can listen. If parents say "his cry just sounds different," trust your ears and track the skill. Note pitch, length, and how hard the child is to soothe. Pair this clue with eye-contact and name-response checks for a fuller early-risk picture.

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During intake, record the child’s cry for 30 seconds and note any shrill or machine-like quality in the file.

02At a glance

Intervention
not applicable
Design
other
Sample size
18
Population
autism spectrum disorder, developmental delay, neurotypical
Finding
not reported

03Original abstract

Distress emotions in very young children are manifest in vocal, facial, and bodily cues. Moreover, children with different developmental conditions (i.e. Autistic Disorder- AD, Developmental Delay- DD, Typically Developing- TD) appear to manifest their distress emotions via different channels. To decompose channel of emotional distress display by group, we conducted a study in which video clips of crying of 18 children 18 months of age belonging to three groups (AD, DD, TD) were modified to isolate vocal, facial, or bodily cues, and 42 female adults were asked to judge the distress and typicality (expected normality) of the different stimuli. We find variation in adult judgements of distress and typicality by child group (AD, DD, TD) and by isolated cues (vocal, facial, or body). Although there is some overlap between responses to episodes of crying of children with AD and those with DD, the different cues of crying of children with AD tend to be considered more atypical and distressed than those of the other two groups (DD and TD). Early assessment of different cues of the expression of distress, and more generally of emotional expressivity in a child, may provide useful information for pediatricians and practitioners who are in contact with young children and must make clinical screening decisions. The findings also alert parents of children with AD to important aspects of their cries.

Research in autism spectrum disorders, 2011 · doi:10.1016/j.rasd.2011.02.013