Can combining existing behavioral tools improve identification of infants at elevated likelihood of autism in the first year of life?
Meagan R Talbott, Gregory S Young, Sally Ozonoff
PMID 39264002WHAT IT FOUND
At 12 months, 19 of 20 infants with both high observation-scale scores and low Mullen scores were later classified with autism or another developmental concern, but few infants met this combined rule.
Key findings
01At 12 months, 19 of 20 infants with both high AOSI and low Mullen scores were later classified with autism or another developmental concern.
02At 6 months, 61 of 122 typically developing infants scored above the cutoff on at least one measure, but only 14 of 110 scored above the cutoff on two measures.
03At 12 months, high observation-scale scores plus low Mullen scores improved prediction over the observation scale alone, parent concerns, or any single marker.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was enriched for autism risk because all main-analysis infants had an older autistic sibling, so results may not apply to infants in the general community. Very few infants met combined marker definitions, especially all three markers, so some estimates were imprecise. At 6 and 9 months, confidence intervals overlapped across most definitions, so the study did not show a clear advantage for combined markers at those ages. Sensitivity was low across ages, so the rules missed many infants who later had developmental concerns. The outcome combined autism and other non-typical development, so the rules do not distinguish autism from other developmental delays. The study used trained examiners and standardized assessments, which may be too costly for routine screening settings.
Declared interests
The work was supported by NIH grants, including NIMH, NICHD, and NCATS funding. M.R.T. and S.O. reported NIH research grant funding. S.O. also reported research grant funding from the Autism Science Foundation and book royalties from Guilford Press.
The easy way to misread this
Do not read the 19 of 20 result at 12 months as evidence that these tests can identify most infants who will later have autism or developmental concerns. The infants were siblings of autistic children, the combined rule flagged very few infants, and sensitivity was low, so many later concerns were not detected in the first year.