Early gesture development as a predictor of autism spectrum disorder in elevated-likelihood infants of ASD.
Missing gesture blends like point-plus-give between 12–16 months forecast autism in high-risk infants.
01Research in Context
What this study did
Liu et al. (2024) watched babies who have an older sibling with autism. These babies have a higher chance of autism themselves.
The team tracked how the babies used gestures like pointing or giving toys from 12 to 16 months. They wanted to see which gesture patterns predicted an autism diagnosis later.
What they found
Babies later diagnosed with autism were slower to combine gestures with other actions. For example, they rarely pointed at a toy and then handed it to mom.
This gesture-integration gap showed up before any words were expected, making it an early red flag.
How this fits with other research
Özcan et al. (2025) extends the finding. They showed that even after babies learn to walk, the same high-risk group does not get the usual jump in pointing or waving. Walking alone does not fix the gesture gap.
Warreyn et al. (2005) and Pilgrim et al. (2000) saw similar joint-attention deficits, but in older children or through parent recall. Liu’s work pins the first clear marker between 12–16 months.
Brisson et al. (2012) found another early motor red flag: babies later diagnosed with autism rarely open their mouth on time during spoon-feeding. Together, these studies map a chain of motor–communication disconnects starting in the first year.
Why it matters
If you work with infants who have siblings with autism, watch for missing point-plus-give or point-plus-show combos between 12–16 months. When these blends are absent, start gentle joint-attention games right away—stack blocks, roll balls, or use hand-over-hand pointing during play. Catching the gap early gives you time to shape social communication before words are expected.
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02At a glance
03Original abstract
Gesture difficulties have been reported in later-born siblings of children with autism spectrum disorder (ASD). Careful observation of gesture development during the first two years of children at elevated likelihood (EL) of developing ASD may identify behavioral indicators that facilitate early diagnosis. This study enrolled 47 EL infants and 27 low-likelihood (LL) infants to explore gesture developmental trajectories and the predictive value of gesture to expedite the early detection of core characteristics of ASD. Gesture frequency, communication function, and integration ability were observed and coded from a semi-structured assessment administered longitudinally across 9–19 months of age. We conducted the Autism Diagnostic Observation Schedule assessment at 18–19 months for ASD’s core characteristics. The development of joint attention (JA) gestures was slower in the EL than in the LL group. The trajectories of the two groups began to diverge at 14–18 months. Children who reached the diagnostic cutoff point for ASD showed reductions in social interaction gestures at 12–13 months, in gestures integrated with any two communication skills (G-M) at 15–16 months; and in gestures integrated with eye contact (G-E) at 18–19 months. Overall gesture and G-M integration were associated with an overall ADOS communication and social interaction score. The developmental trajectories of JA gestures of EL and LL children differed. G-M gestures represent early indicators that may be a predictor of ASD. The online version contains supplementary material available at 10.1186/s12888-024-06173-5.
BMC Psychiatry, 2024 · doi:10.1186/s12888-024-06173-5