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Pre-Verbal Communication Could Help in Early Autism Detection


Autism spectrum (ASD) is diagnosed through a variety of measures, including verbal, nonverbal, visual, and attentional factors. Because of this, most diagnoses are not received before age 3. But knowing what to look for in children at risk for ASD could provide earlier diagnoses, or at least give children in high risk categories access to resources that could help them address developmental challenges at the earliest possible moment. However, longitudinal studies designed to identify infant and pre-verbal signs of autism would require immense efforts and exhaustive research. Therefore, Breanna M. Winder of the Department of Psychology at Bryn Mawr College in Pennsylvania sought to accomplish a similar goal through a more feasible avenue of research.

Using a sample of 15 children at low risk (LR) for ASD and 15 high risk (HR) infants who were siblings of a child with ASD, Winder evaluated several aspects of verbal and nonverbal communication development when the children were 13, 18, and 36 months of age. Specifically, she looked at how spontaneously the children produced words, gestures, non-word vocalizations with gestures, and communicative non-word verbalizations (CNWVs). She found that the HR children had much lower rates of CNWVs at 13 months and all behaviors at 18 months when compared to the LR children. Winder said, “As a group and across age, HR infants spontaneously initiated communication at lower rates than their LR peers.” Even though only three of the children eventually received a diagnosis of ASD, the HR children all performed far below the LR children through the 36-month time period. The three children who received a diagnosis of ASD at 36 months were at the bottom of all the scales over the entire study period.

Winder believes that clinical implications can be drawn from these results. First, by recognizing CNWVs early on, parents and caregivers can identify what children may be at risk for ASD. Also, encouraging verbal and non-verbal communication in the home can be an effective way to help children with developmental delays, especially those already at heightened risk for ASD. Further, future work could extend these findings through broader and more diverse samples. “These studies represent first steps in what should become a focused effort,” said Winder.

Winder, B. M., Wozniak, R. H., Parladé, M. V., and Iverson, J. M. (2012). Spontaneous initiation of communication in infants at low and heightened risk for autism spectrum disorders. Developmental Psychology. Advance online publication. doi: 10.1037/a0031061

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  • Laurel February 4th, 2013 at 4:52 PM #1

    Seriously? There are many, many signs that parents and care givers can look for, and have already been well-documented. However, as a mother of an 18 year old with high functioning autism, I am completely incensed at the insinuation that we did not encourage verbal and non verbal communication in our AS children. Our first son was talking before he could walk. The second one, with autism, hit ALL OF HIS MARKS at the EXACT SAME TIME as the older one… but it was a gradual decline which it took a while to see and also we had bad advice from many professionals who should’ve known better. And in our case, we were further lead down the garden path because of chronic ear infections. It was explained to us by the doctor that the fluid in his ears was the problem. That is why he was slow to speak and to speak clearly. It was the reason for the intense rages. etc.

    Certainly, parents should encourage communication, but an autistic brain requires an INTENSIVE intervention in order to have any hope of improvement for the long term. Please stop inferring that the parents have any responsibility for this disorder. Children are born that way and it has been determined that it is largely genetic.

    It is our job as parents to get them the help that they need and as early as possible.

  • Cason February 5th, 2013 at 3:41 AM #2

    What about the parents who insist that there were absolutely no signs that either they or a pediatrician saw until a certain age, and usually after some round of vaccines have been given? Surely this is an indicator that in more cases than we are willing to admit there are environmental factors that would heavily lean toward autism development, especially when there was nothing wrong before.

  • Liz February 5th, 2013 at 8:50 AM #3

    Laurel, I find your response very interesting. My sweet little nephew who is eleven months old is being evaluated today by a team of a special education teacher and other folks. I am a little unclear as to who is involved and if it is through a private company or if it’s a state/federal program. Anyway, he also just had tubes put in his ears on Friday b/c of chronic ear infections. He doesn’t have rages (maybe too young?), but he was constantly whiney whenever we’d Facetime with them. Maybe it was just wishful thinking on my part, but when we Facetimed on Friday afternoon, he seemed so much more cheerful and wasn’t clinging to his mom like he usually does. I don’t know if any of this has anything to do with anything, but I am just a worried aunt and needed to get my thoughts out!

  • Sasha February 5th, 2013 at 8:53 AM #4

    Disclaimer-I am in NO way saying Autism is not a valid disorder that is destructive and needs to be stopped. But, I am curious about something-where was this disorder thirty years ago? I don’t recall attending school with one person who was diagnosed with ASD, and I graduated from high school in 1992.

  • u. yahn February 5th, 2013 at 8:55 AM #5

    i am hoping somebody finds out how to fix this so no more kids an dparents hav eto suffer. my grandbaby has this and it is so heartbreaking. makes me so sad and mad at the same time.

  • Wade February 5th, 2013 at 8:57 AM #6

    Cason, I thought studies had ruled out vaccinations as a cause of Autism? Or, is that just the drug companies behind the studies swaying the results? It’s so hard to know who to trust when it comes to studies since statistics can be displayed anyway you’d like them to be. I wish there was a source we could all turn to and know we are being given the unbiased truth.

  • Polly February 5th, 2013 at 3:20 PM #7

    Studies such as these sounds encouraging, Mainly because they are not advocating medication but merely encouraging closer monitoring. As parents it would be our duty to be aware and look for signs. Better be safe than sorry.

    And if things such as these can be put across to parents and the disorder or even an at-risk situation identified much earlier there are far more chances of improvement and treatment. Now that certainly is a good thing and I’m sure everybody would agree(?)

  • Cason February 5th, 2013 at 3:56 PM #8

    @Wade- I don’t think that there is necessarily definitive prrof one way or the other. But that sure is an interesting theory that you propose about big pharma and their role in either getting the truth out or participating in a big cover up. I don’t believe that they would ever create any drug that would KNOWINGLY harm someone but I don’t think that they would be the first ones to accept blame for anything when it goes wrong either. It is hard to know who to trust, who to believe anymore and that’s kind of sad.

  • russell February 5th, 2013 at 10:52 PM #9

    do the results hold any promise at all?because there have been so many cases where early development was normal but the children later went on to have autism.if it is not a definitive way of predicting then it not only is not right but could also provide a false sense of security.

  • Paige February 8th, 2013 at 11:15 AM #10

    But how do you know what is normal and what isn’t at these young ages if you aren’t a psychologist?
    Maybe the signs are there but many new parents aren’t sure what they should be on the lookout for

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