Autism in Infants and Young Children

Introduction

In this section, we aim to cover the social disorders in infants and young children. The lecture covers the patterns of onset of autism in young children and the diagnosis, the syndrome expression and atypical face processing in toddlers with ASD.

Featured Reading

Featured reading from the Autism in Infants and Young Children lecture comes from:

Chawarska, K., Klin, A., Paul, R., & Macari, S., Volkmar, F.R. (2009). A Prospective Study of Toddlers with ASD: Short-Term Diagnostic and Cognitive Outcomes. Journal of Child Psychology and Psychiatry. 50:10, 1253-1245.

This study extended findings of the 2007 study on stability and variability in syndrome expressions providing a roadmap for others seeking to implement early diagnostic procedures. It confirmed the high stability of the ASD diagnosis but also documented significant movement within the ‘spectrum’ in terms of diagnostic assignment at entry and at follow up. An analysis of developmental skills profiles suggested particular relevance of the assessment of verbal and nonverbal communication skills to diagnostic differentiation between subtypes within the ASD in the second year of life.

Read the full text article online at Wiley InterScience from the Journal of Child Psychology and Psychiatry.

Reading List

Chawarska, Volkmar, & Klin (2010). Not a Captive Audience: Attentional abnormalities in response to faces in toddlers with ASD. Archives of General Psychiatry.

This study employed the overlap attention cueing paradigm to study disengagement from faces in ASD and typical toddlers and provided replication and extension of earlier work published in 2003. The results demonstrated that in ASD deficits in attentional engagement with faces are present early in development, are specific to this disorder, and relatively robust as they are preserved across experimental conditions. Thus, deficits in face recognition in ASD are associated with a limited depth of processing of these highly socially and biologically relevant stimuli. This study also refuted an accepted belief in the field that some of the social deficits associated with ASD might be due to generic difficulties in disengaging and shifting attention.

Chawarska K, Klin A, Paul R, Volkmar F. (2007) Autism spectrum disorder in the second year: Stability and change in syndrome expression. Journal of Child Psychology and Psychiatry Vol 48(2), 128-138.

This was one of the first studies in the field to report on stability of clinical diagnosis of ASD in a sample of children under the age of 2 years. It documented that symptoms of autism and PDD-NOS in the second year were pronounced and stability of the clinical diagnosis was high. The agreement between clinician-assigned autism but not PDD-NOS diagnosis and the ADOD-G (standard observational diagnostic scale for autism in children with mental age over 24 months) was high. However, sensitivity of the ADI-R (standard diagnostic interview tool) diagnostic classification of autism was poor. Comparison of concurrent parental report and direct observation revealed discrepancies in severity ratings of key dyadic social behaviors that are highly consequential for design and interpretation of parent-report based screening instruments. The study provided support for stability of clinical diagnosis and syndrome expression in the second year and highlighted advantages and limitations of the gold-standard diagnostic instruments (ADI-R and ADOS-G) for diagnosing and documenting symptoms of ASD in late infancy.

Read the full text article online at the PubMed Central website.

Chawarska, K., Klin, A., Paul, R., & Macari, S., Volkmar, F.R. (2009). A Prospective Study of Toddlers with ASD: Short-Term Diagnostic and Cognitive Outcomes. Journal of Child Psychology and Psychiatry. 50:10, 1253-1245.

This study extended findings of the 2007 study on stability and variability in syndrome expressions providing a roadmap for others seeking to implement early diagnostic procedures. It confirmed the high stability of the ASD diagnosis but also documented significant movement within the ‘spectrum’ in terms of diagnostic assignment at entry and at follow up. An analysis of developmental skills profiles suggested particular relevance of the assessment of verbal and nonverbal communication skills to diagnostic differentiation between subtypes within the ASD in the second year of life.

Read the full text article online at Wiley InterScience from the Journal of Child Psychology and Psychiatry.

Chawarska, K., Klin, A., & Volkmar, F.(Eds) (2008). Autism in Infants and Toddlers: Diagnosis, Assessment and Treatment. Guilford Press, New York, NY, pp. 347.

Although the earliest symptoms of autism spectrum disorders (ASD) often appear before a child’s second birthday, diagnosis is often delayed until the child reaches preschool age. Researchers and clinicians have been striving to bridge the gap between symptom onset and the time of diagnosis and initiation of treatment. This volume contains a critical review of current issues related to classification, diagnosis, assessment, and treatment of ASD in infants and toddlers. Experts in the field share their clinical insights as well empirical findings that can be readily translated into practice. The book is addressed to psychologists, psychiatrists, pediatricians, educators, early intervention providers, speech and language pathologists, and social workers, as well as to parents.

Chapter 7, Working with Young Children, from "A Practical Guide to Autism".

Volkmar, Fred; Wiesner, Lisa. "A Practical Guide to Autism". John Wiley & Sons, Inc. New Jersey, 2009.

Find this book online at the Publisher's website.

Media and Other Resources

External Resources

Globalization's Challenge to Islam
Sociologist and scholar of Islam Riaz Hassan highlights the tensions globalization brings to the diversity present in the Muslim world, and argues for the acceptance of diffuse and differentiated Islamic communities rather than a monolithic notion of Islam.

Movement May Offer Early Clue to Autism- NYTimes
Dr. Philip Teitelbaum, a psychologist at the University of Florida in Gainesville, has found that autistic children appear to have subtle abnormalities in body movements. This discovery has raised hopes that there may be a reliable way to diagnose autism earlier than is currently customary (most autism is not diagnosed in children until they are at least three years old).

When to Worry if a Child Has Too Few Words- NYTimes
This article addresses issues in the clinical diagnosis of delayed speech and language in children.

Faculty and Guest Bios

Bio Profile

Katarzyna Chawarska, PhD

Professor in the Child Study Center

Director, Yale Toddler Developmental Disabilities Clinic

Director, Yale Early Social Cognition Program

Education

PhD, Yale University, 2000

MA, Jagiellomian Univ., 1986

Research Interests

Attention; Autistic Disorder; Child Psychiatry; Developmental Disabilities; Human Development; Mental Disorders; Pediatrics; Perception; Prodromal Symptoms; Psychophysiology; Technology

Clinical Interests

Autistic Disorder; Developmental Disabilities

Dr. Chawarska has received her clinical and research training at Yale. She is a leading expert in research on identifying markers of autism spectrum disorders (ASD) and novel treatment targets in infancy. In her clinical practice, Dr. Chawarska specializes in early diagnosis of ASD as well as developmental follow-up of infants at risk for ASD due to familial factors (e.g., having an older sibling with ASD), genetic factors (e.g., having a syndrome related to ASD such as Fragile X), or due to...

View Full Profile