Reciprocal Associations Between Language Ability and Social Functioning Development in Pre-verbal Autistic Children.
ASD can be spotted at 18 months, and the kids flagged earliest need immediate adaptive-language support because their gap only widens.
01Research in Context
What this study did
The team followed baby siblings of children with autism. They gave an ASD diagnosis at 18 months.
They checked the same children again at age three. The goal was to see if the early label stuck and how skills grew.
What they found
Eight out of ten toddlers still met ASD criteria at age three. The kids who got the label soonest had the lowest language and daily-living scores.
Early diagnosis did not cause the low scores. It just flagged the kids who needed the most help.
How this fits with other research
Austin et al. (2015) saw the same group and found big IQ jumps between preschool and kindergarten, but tiny adaptive gains. R et al. now show those weak daily-living scores are already visible in infancy.
Pathak et al. (2019) widened the lens to older kids and found the IQ-adaptive gap keeps growing. Deserno et al. (2017) pushed further, showing the gap lasts into adulthood and brings anxiety and depression along for the ride.
Schaal et al. (1990) once thought autistic kids out-performed IQ-matched peers in daily skills during childhood. The new data say the opposite: the earliest-diagnosed kids start lower and stay behind, updating the old view.
Why it matters
If you assess a toddler at 18 months and give an ASD diagnosis, do not wait to target adaptive skills. Start dressing, feeding, and joint-play programs right away. Track the gap every six months; when it widens, add social-skills and caregiver coaching. Early labels are reliable, and acting early can bend the long-term curve shown by later studies.
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02At a glance
03Original abstract
Children with autism spectrum disorder (ASD) are diagnosed, on average, around the age of 4 years. However, previous research has shown that the diagnosis can be made as early as 2 years, and that if the child is seen a year or more later, it is highly likely that the diagnosis will be confirmed. In this study, to examine whether diagnoses made as early as 18 months of age are also "stable," we followed a group of younger siblings of children with ASD (who are known to be at higher risk). We also examined whether the age of ASD diagnosis within this high-risk group was related to the severity of children's ASD symptoms or developmental delays. Participants (n = 381) were seen at three ages: 18 months, 24 months, and 3 years. ASD symptoms, general development, and adaptive functioning were assessed at each time point. Twenty-three children were diagnosed with ASD at 18 months and a total of 61 at 24 months. Of these diagnoses, 19/23 (82.6%) and 56/61 (91.8%), respectively, were confirmed independently at 3 years. However, 45 children were diagnosed with ASD at 3 years who had not been identified at earlier visits. Children diagnosed at 18 months, in comparison to those diagnosed at 24 months, had less advanced language and adaptive skills at 18 months. Children not diagnosed with ASD until 3 years, compared with those diagnosed earlier, had more advanced language and adaptive skills, and milder ASD symptoms. Autism Res 2016, 9: 790-800. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
Journal of autism and developmental disorders, 2024 · doi:10.1002/aur.1585