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There is considerable need for adoptable evidence-based interventions for implementation in public classrooms serving children with autism spectrum disorders (ASD) during the preschool years, an important period in neurodevelopment. Barriers to implementation, including gaps in teacher education, contribute to the research-to-practice gap, and may compromise child outcomes. This qualitative study collected ongoing verbal and written feedback from educators (n = 8) and administrators (n = 3) during their participation in the iterative development phase of a larger project to translate and preliminarily trial an evidence-based intervention, Early Achievements, in public preschool classrooms. Using a grounded theory-based approach, barriers were identified in areas of educator preparedness, engagement, and cohesion, complexity of instructing students with ASD, limited time/resources, and administrator support. Educators and administrators differed in their perspectives. Innovative strategies are presented for enhancing transportability, along with discussion of implications for teacher education practices and related policy.

Purpose: Social communication or pragmatic skills are continuously distributed in the general population. Impairment in these skills is associated with two clinical disorders, autism spectrum disorder (ASD) and social (pragmatic) communication disorder. Such impairment can impact a child's peer acceptance, school performance, and current and later mental health. Valid, reliable, examiner-rated observational measures of social communication from a semistructured language sample are needed to detect social communication impairment. We evaluated the psychometrics of an examiner-rated measure of social (pragmatic) communication, the Pragmatic Rating Scale--School Age (PRS-SA). Method: The analytic sample consisted of 130 children, ages 7-12 years, from five mutually exclusive groups--ASD (n = 25), language concern (LC; n = 5), ASD + LC (n = 10), social communication impairment only (n = 22), and typically developing (TD; n = 68). All children received language and autism assessments. The PRS-SA was rated separately using video-recorded communication samples from the Autism Diagnostic Observation Schedule. Assessment data were employed to evaluate the psychometrics of the PRS-SA. Analysis of covariance models were used to assess whether the PRS-SA would detect differences in social communication functioning across the five groups. Results: The PRS-SA demonstrated strong internal reliability, concurrent validity, and interrater reliability. PRS-SA scores were significantly higher in all groups compared to the TD group and differed significantly in most pairwise comparisons; the ASD + LC group had the highest (more atypical) scores. Conclusions: The PRS-SA shows promise as a measure of social communication skills in school-age verbally fluent children with a range of social and language abilities. More research is needed with a larger sample, including a wider age range and geographical diversity, to replicate findings.

Little empirical evidence exists about school-age pragmatic communication or predictors in siblings at heightened familial risk for ASD (HR) and low-risk (LR) controls. The "Pragmatic Rating Scale-School-Age" (Landa unpublished) was scored for 49 HR siblings and 18 LR controls at 8-12 years. Social-communication and language measures were collected between 14 and 36 months. At 36-months, siblings were classified as ASD (HR-ASD, n = 15), broad autism phenotype (HR-BAP, n = 19), or typically developing (HR-TD, n = 15). Results revealed a pragmatic continuum with significantly better scores for HR-TD than HR-BAP or HR-ASD, and HR-BAP than HR-ASD. Per regression models including all participants, 14-month joint attention initiations predicted school-age pragmatic communication, as did 24-month social-communication and expressive language scores. Early joint attention, social-communication, and language abilities contribute to later pragmatic functioning.

ObjectivesAutism spectrum disorder (ASD) is estimated to be ∼10 times higher in children with versus without an autistic sibling in population-based studies. Prospective studies of infant siblings have revealed even higher familial recurrence rates. In the current prospective longitudinal study, we provide updated estimates of familial ASD recurrence using a multinational database of infants with older autistic siblings.MethodsData were collated across 18 sites of the Baby Siblings Research Consortium, an international network studying the earliest manifestations of ASD. A total of 1605 infants with an older autistic sibling were followed from early in life to 3 years, when they were classified as ASD or non-ASD. Hierarchical generalized linear modeling, with site as a random effect, was used to examine predictors of recurrence in families and calculate likelihood ratios.ResultsA total of 20.2% of siblings developed ASD, which is not significantly higher than the previously reported rate of 18.7%. Male infant sex and >1 older affected sibling were significant predictors of familial recurrence. Proband sex also influenced recurrence rates, with siblings of female probands significantly more likely to develop ASD than siblings of male probands. Race and maternal education were also associated with recurrence in families.ConclusionsThe familial recurrence rate of ASD, as measured in infant sibling studies, has not changed appreciably since previous estimates were made in 2011. Younger siblings of autistic children, particularly those who are male, have an affected female sibling, multiple affected siblings, or are impacted by social inequities, should be closely monitored and promptly referred for diagnostic evaluation.

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multitude of novel scientific challenges. The Autism Speaks Toddler Treatment Network (ASTTN) was formed in 2007 to provide an infrastructure for ongoing communication between the investigators of eight research projects evaluating parent-mediated interventions for toddlers with ASD. The present article describes and compares the research studies of the ASTTN; highlights specific challenges with regard to research design, participants, recruitment, eligibility criteria, enrollment, and intervention approach; and outlines practical considerations that may guide the next generation of parent-mediated intervention studies involving toddlers with ASD.

Retrospective studies indicate 2 major classes of autism spectrum disorder (ASD) onset: early and later, after a period of relatively healthy development. This prospective, longitudinal study examined social, language, and motor trajectories in 235 children with and without a sibling with autism, ages 6-36 months. Children were grouped as: ASD identified by 14 months, ASD identified after 14 months, and no ASD. Despite groups' initial similar developmental level at 6 months, ASD groups exhibited atypical trajectories thereafter. Impairment from 14 to 24 months was greater in the Early-ASD than the Later-ASD group, but comparable at 36 months. Developmental plateau and regression occurred in some children with ASD, regardless of timing of ASD diagnosis. Findings indicate a preclinical phase of varying duration for ASD. (Contains 1 figure and 2 tables.)

Background: Siblings of children with autism (sibs-A) are at increased genetic risk for autism spectrum disorders (ASD) and milder impairments. To elucidate diversity and contour of early developmental trajectories exhibited by sibs-A, regardless of diagnostic classification, latent class modeling was used. Methods: Sibs-A (N = 204) were assessed with the Mullen Scales of Early Learning from age 6 to 36 months. Mullen T scores served as dependent variables. Outcome classifications at age 36 months included: ASD (N = 52); non-ASD social/communication delay (broader autism phenotype; BAP; N = 31); and unaffected (N = 121). Child-specific patterns of performance were studied using latent class growth analysis. Latent class membership was then related to diagnostic outcome through estimation of within-class proportions of children assigned to each diagnostic classification. Results: A 4-class model was favored. Class 1 represented accelerated development and consisted of 25.7% of the sample, primarily unaffected children. Class 2 (40.0% of the sample), was characterized by normative development with above-average nonverbal cognitive outcome. Class 3 (22.3% of the sample) was characterized by receptive language, and gross and fine motor delay. Class 4 (12.0% of the sample), was characterized by widespread delayed skill acquisition, reflected by declining trajectories. Children with an outcome diagnosis of ASD were spread across Classes 2, 3, and 4. Conclusions: Results support a category of ASD that involves slowing in early non-social development. Receptive language and motor development is vulnerable to early delay in sibs-A with and without ASD outcomes. Non-ASD sibs-A are largely distributed across classes depicting average or accelerated development. Developmental trajectories of motor, language, and cognition appear independent of communication and social delays in non-ASD sibs-A. (Contains 2 figures and 3 tables.)

Little is known about whether early symptom presentation differs in toddlers with ASD from ethnic minority versus non-minority backgrounds. Within a treatment study for toddlers with ASD, we compared 19 minority to 65 Caucasian children and their parents on variables obtained from the Mullen Scales of Early Learning, Autism Diagnostic Observation Schedule, and Communication and Symbolic Behavior Scales Caregiver Questionnaire. The majority of parents were from the upper classes irrespective of ethnic membership. Minority children had lower scores in language, communication, and gross motor than non-minority children. Findings indicate that subtle communication delays may be undetected or presumed unremarkable by parents of minority toddlers, and that more significant delays are needed to prompt the search for intervention services.

Parents' concerns about their children's development were examined prospectively at 14, 24, and 36 months for 89 younger siblings of a child with autism. Parent reported concern was high at all ages (40-75%) and was higher at 24 and 36 months in children with ASD than non-ASD outcomes (p less than 0.05). Communication concerns were reported most frequently. Parent concern compared to impairment classification based on concurrent standardized tests provided better specificity than sensitivity, and was better for communication than social functioning. Parent communication concern (but not social concern) at 24 months and 36 months predicted ASD versus non-ASD outcome; however, children's impairment on standardized tests yielded greater predictive value at all ages (p less than 0.001). Close monitoring of this at risk group is warranted.

Background: Social and communication impairments are core deficits and prognostic indicators of autism. We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders (ASD). Methods: Fifty toddlers with ASD, ages 21 to 33 months, were randomized to one of two six-month interventions: Interpersonal Synchrony or Non-Interpersonal Synchrony. The interventions provided identical intensity (10 hours per week in classroom), student-to-teacher ratio, schedule, home-based parent training (1.5 hours per month), parent education (38 hours), and instructional strategies, except the Interpersonal Synchrony condition provided a supplementary curriculum targeting socially engaged imitation, joint attention, and affect sharing; measures of these were primary outcomes. Assessments were conducted pre-intervention, immediately post-intervention, and, to assess maintenance, at six-month follow-up. Random effects models were used to examine differences between groups over time. Secondary analyses examined gains in expressive language and nonverbal cognition, and time effects during the intervention and follow-up periods. Results: A significant treatment effect was found for socially engaged imitation (p = 0.02), with more than doubling (17% to 42%) of imitated acts paired with eye contact in the Interpersonal Synchrony group after the intervention. This skill was generalized to unfamiliar contexts and maintained through follow-up. Similar gains were observed for initiation of joint attention and shared positive affect, but between-group differences did not reach statistical significance. A significant time effect was found for all outcomes (p less than 0.001); greatest change occurred during the intervention period, particularly in the Interpersonal Synchrony group. Conclusions: This is the first ASD randomized trial involving toddlers to identify an active ingredient for enhancing socially engaged imitation. Adding social engagement targets to intervention improves short-term outcome at no additional cost to the intervention. The social, language, and cognitive gains in our participants provide evidence for plasticity of these developmental systems in toddlers with ASD. http://www.clinicaltrials.gov/ct2/show/NCT00106210?term = landa&rank = 3. (Contains 3 tables and 1 figure.)

This study examined language and executive functions (EF) in high-functioning school-aged individuals with autism and individually matched controls. Relationships between executive, language, and social functioning were also examined. Participants with autism exhibited difficulty on measures of expressive grammar, figurative language, planning, and spatial working memory. A mixed profile of impaired and enhanced abilities was noted in set-shifting. While controls showed the typical increase in errors when shifting sets from an intra-dimensional to an extra-dimensional stimulus, this pattern was not noted in participants with autism. Relationships between EF, language, and social performance were weak to nonexistent. Implications for theories of core deficit in autism and dissociable nature of the language and executive impairments in autism are discussed.

This paper orients the reader to social communication assessment and reviews methods for assessing social communication behavior in children from toddlerhood through the preschool years. Most standardized, normed tests of language in this age range focus on morpho-syntactic and semantic comprehension and production abilities. While social communication is perhaps one of the most important skills for peer acceptance, these skills are often overlooked in language evaluation with children. However, there are a number of caregiver questionnaires, interviews, or direct social-communication sampling methods that are available to assist clinicians or researchers in documenting social-communication skills or behaviors. Since assessment of social communication is essential in clinical work with children with an autism spectrum disorder, some of the tools described below are outgrowths of autism research or provide autism-related scores. While many children receiving social communication assessments do not have autism, the need to assess social communication skills in children with language impairment is highlighted by the growing literature documenting social and pragmatic difficulties in this population (Bishop 2000 Causes, Characteristics, Intervention, and Outcome. Hove, UK: Psychology press). Regardless of whether the measures presented herein were initially designed for children with autism or not, they will provide insights into the social communicative behaviors or tendencies in young children.

Research has identified early appearing differences in gross and fine motor abilities in infants at heightened risk (HR) for autism spectrum disorder (ASD) because they are the younger siblings of children with ASD, and it suggests that such differences may be especially apparent among those HR infants themselves eventually diagnosed with ASD. The present study examined overall and item-level performance on the gross (GM) and fine motor (FM) subscales of the Mullen Scales of Early Learning (MSEL) administered at 6 months to a large, geographically diverse sample of HR infants with varying developmental outcomes (ASD, elevated ADOS without ASD, low ADOS without ASD) and to infants with low ASD risk (low risk [LR]). We also explored whether motor abilities assessed at 6 months predicted ASD symptom severity at 36 months. FM (but not GM) performance distinguished all 3 HR groups from LR infants with the weakest performance observed in the HR-Elevated ADOS children, who exhibited multiple differences from both LR and other HR infants in both gross and fine motor skills. Finally, 6-month FM (but not GM) scores significant predicted 36-month ADOS severity scores in the HR group; but no evidence was found of specific early appearing motor signs associated with a later ASD diagnosis. Vulnerabilities in infants' fine and gross motor skills may have significant consequences for later development not only in the motor domain but in other domains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

BackgroundThe diagnosis of autism spectrum disorder (ASD) made before age 3 has been found to be remarkably stable in clinic- and community-ascertained samples. The stability of an ASD diagnosis in prospectively ascertained samples of infants at risk for ASD due to familial factors has not yet been studied, however. The American Academy of Pediatrics recommends intensive surveillance and screening for this high-risk group, which may afford earlier identification. Therefore, it is critical to understand the stability of an ASD diagnosis made before age 3 in young children at familial risk.MethodsData were pooled across seven sites of the Baby Siblings Research Consortium. Evaluations of 418 later-born siblings of children with ASD were conducted at 18, 24, and 36 months of age and a clinical diagnosis of ASD or Not ASD was made at each age.ResultsThe stability of an ASD diagnosis at 18 months was 93% and at 24 months was 82%. There were relatively few children diagnosed with ASD at 18 or 24 months whose diagnosis was not confirmed at 36 months. There were, however, many children with ASD outcomes at 36 months who had not yet been diagnosed at 18 months (63%) or 24 months (41%).ConclusionsThe stability of an ASD diagnosis in this familial-risk sample was high at both 18 and 24 months of age and comparable with previous data from clinic- and community-ascertained samples. However, almost half of the children with ASD outcomes were not identified as being on the spectrum at 24 months and did not receive an ASD diagnosis until 36 months. Thus, longitudinal follow-up is critical for children with early signs of social-communication difficulties, even if they do not meet diagnostic criteria at initial assessment. A public health implication of these data is that screening for ASD may need to be repeated multiple times in the first years of life. These data also suggest that there is a period of early development in which ASD features unfold and emerge but have not yet reached levels supportive of a diagnosis.

ObjectiveAlthough early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with ASD from a high-risk (HR) sample of infant siblings of children with ASD (by definition, multiplex), HR siblings not diagnosed with ASD, and low-risk (LR) controls.MethodParticipants included 442 HR and 253 LR infants from 12 sites of the international Baby Siblings Research Consortium. Longitudinal HC data were obtained prospectively, supplemented by growth records. Random effects nonlinear growth models were used to compare HC in HR infants and LR infants. Additional comparisons were conducted with the HR group stratified by diagnostic status at age 3: ASD (n = 77), developmental delay (DD; n = 32), and typical development (TD; n = 333). Nonlinear growth models were also developed for height to assess general overgrowth associated with ASD.ResultsThere was no overall difference in head circumference growth over the first 3 years between HR and LR infants, although secondary analyses suggested possible increased total growth in HR infants, reflected by the model asymptote. Analyses stratifying the HR group by 3-year outcomes did not detect differences in head growth or height between HR infants who developed ASD and those who did not, nor between infants with ASD and LR controls.ConclusionHead growth was uninformative as an ASD risk marker within this HR cohort.

Autism spectrum disorder (ASD) is an increasingly prevalent and heterogeneous neurodevelopmental condition, characterized by social communicative differences, and a combination of repetitive behaviors, focused interests, and sensory sensitivities. Early speech and language delays are characteristic of young autistic children and are one of the first concerns reported by parents; often before their child's second birthday. Elucidating the neural mechanisms underlying these delays has the potential to improve early detection and intervention efforts. To fill this gap, this systematic review aimed to synthesize evidence on early neurobiological correlates and predictors of speech and language development across different neuroimaging modalities in infants with and without a family history of autism [at an elevated (EL infants) and low likelihood (LL infants) for developing autism, respectively]. A comprehensive, systematic review identified 24 peer-reviewed articles published between 2012 and 2023, utilizing structural magnetic resonance imaging (MRI; n = 2), functional MRI (fMRI; n = 4), functional near-infrared spectroscopy (fNIRS; n = 4), and electroencephalography (EEG; n = 14). Three main themes in results emerged: compared to LL infants, EL infants exhibited (1) atypical language-related neural lateralization; (2) alterations in structural and functional connectivity; and (3) mixed profiles of neural sensitivity to speech and nonspeech stimuli, with some differences detected as early as 6 weeks of age. These findings suggest that neuroimaging techniques may be sensitive to early indicators of speech and language delays well before overt behavioral delays emerge. Future research should aim to harmonize experimental paradigms both within and across neuroimaging modalities and additionally address the feasibility, acceptability, and scalability of implementing such methodologies in non-academic, community-based settings. [ABSTRACT FROM AUTHOR]

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a personcentered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months (M = 33 mo, SD = 12 mo). Next, a multinomial logistic regression analysis was implemented to examine sociodemographic and child-based developmental differences among the identified language and social communication profiles. Three clinically meaningful profiles were identified from parent-rated and clinician-administered measures: Profile 1 (48% of the sample) “Relatively Low Language and Social Communication Abilities,” Profile 2 (34% of the sample) “Relatively Elevated Language and Social Communication Abilities,” and Profile 3 (18% of the sample) “Informant Discrepant Language and Relatively Elevated Social Communication Abilities.” Overall, young autistic children from the lowest-resource households exhibited the lowest language and social communication abilities, and the lowest non-verbal problem-solving and fine-motor skills, along with more features of attention-deficit/hyperactivity disorder and atypical auditory processing. These findings highlight the need for effective community-based implementation strategies for young autistic children from low-resource households and underrepresented communities to improve access to individualized quality care. [ABSTRACT FROM AUTHOR]

Abstract Infant sibling studies have been at the vanguard of autism spectrum disorders (ASD) research over the past decade, providing important new knowledge about the earliest emerging signs of ASD and expanding our understanding of the developmental course of this complex disorder. Studies focused on siblings of children with ASD also have unrealized potential for contributing to ASD etiologic research. Moving targeted time of enrollment back from infancy toward conception creates tremendous opportunities for optimally studying risk factors and risk biomarkers during the pre-, peri- and neonatal periods. By doing so, a traditional sibling study, which already incorporates close developmental follow-up of at-risk infants through the third year of life, is essentially reconfigured as an enriched-risk pregnancy cohort study. This review considers the enriched-risk pregnancy cohort approach of studying infant siblings in the context of current thinking on ASD etiologic mechanisms. It then discusses the key features of this approach and provides a description of the design and implementation strategy of one major ASD enriched-risk pregnancy cohort study: the Early Autism Risk Longitudinal Investigation (EARLI).

• Training in Early Achievements improved childcare providers' classroom instruction. • Implementing the Early Achievements intervention transformed book sharing. • Toddlers with developmental delays improved in social and communication skills. • The Early Achievements intervention fills a research-to-practice gap in childcare. A research-to-practice gap exists in childcare settings, particularly affecting instruction to children with developmental delays (DD) including those with or at risk for autism spectrum disorder (ASD). This study aimed to improve implementation of evidence-based instructional practices by childcare providers in inclusive center-based classrooms; a secondary aim was to examine effects on social and communication outcomes of toddlers with DD and/or ASD. Forty-eight childcare providers from 27 centers and 46 toddlers with social and/or communication delays (mean age = 28.5 months) participated in a cluster-randomized controlled trial. Providers were randomized, at the center level, to Instruction-As-Usual (IAU) or the Early Achievements for Childcare Providers (EA-CP) condition. EA-CP providers received two workshops and weekly, job-embedded coaching. Providers' use of evidence-based instructional practices delivered within a book sharing activity, and toddlers' cognitive, language, and social communication skills were assessed prior to and following training. Significantly greater gains from pre- to post-training in implementation of EA-CP instructional practices were observed in the EA-CP than IAU group (p <.001, d = 7.2). Greater social communication gains were observed in toddlers in EA-CP than IAU classrooms (p <. 001, d = 1.02). Results support the conclusion that the short-term EA-CP professional development program improved implementation of evidence-based instructional practices by childcare providers in inclusive childcare settings, with a direct impact on social and communication outcomes of toddlers with DD, including those with ASD. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) demonstrate a host of motor impairments that may share a common developmental basis with ASD core symptoms. School-age children with ASD exhibit particular difficulty with hand-eye coordination and appear to be less sensitive to visual feedback during motor learning. Sensorimotor deficits are observable as early as 6 months of age in children who later develop ASD; yet the interplay of early motor, visual and social skill development in ASD is not well understood. Integration of visual input with motor output is vital for the formation of internal models of action. Such integration is necessary not only to master a wide range of motor skills, but also to imitate and interpret the actions of others. Thus, closer examination of the early development of visual-motor deficits is of critical importance to ASD. In the present study of infants at high risk (HR) and low risk (LR) for ASD, we examined visualmotor coupling, or action anticipation, during a dynamic, interactive ball-rolling activity. We hypothesized that, compared to LR infants, HR infants would display decreased anticipatory response (perception-guided predictive action) to the approaching ball. We also examined visual attention before and during ball rolling to determine whether attention engagement contributed to differences in anticipation. Results showed that LR and HR infants demonstrated context appropriate looking behavior, both before and during the ball's trajectory toward them. However, HR infants were less likely to exhibit context appropriate anticipatory motor response to the approaching ball (moving their arm/hand to intercept the ball) than LR infants. This finding did not appear to be driven by differences in motor skill between risk groups at 6 months of age and was extended to show an atypical predictive relationship between anticipatory behavior at 6 months and preference for looking at faces compared to objects at age 14 months in the HR group. [ABSTRACT FROM AUTHOR]

Highlights: [•] Parent report on early motor development was compared to standardized assessments. [•] The Early Motor Questionnaire (EMQ) for ages 3–24 months is introduced. [•] Parent's report correlated strongly with examiner-administered assessments. [•] Parents provide reliable and valid information on early motor skills using the EMQ. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine long-term outcomes of toddlers with autism spectrum disorder (ASD) who received a 6-month early intervention at age 2. METHODS: Forty-eight toddlers diagnosed with an ASD received a 6- month evidence-based intervention. Cognitive (IQ) and communication ability, as well as severity of autism symptoms, were assessed by using standardized measures at preintervention (Time 1 [T1]; mean [M] age = 27 months), postintervention (T2; M age = 35 months), short-term follow-up (T3; M age = 41 months), and long-term follow- up (T4; M age = 72 months). RESULTS: From pre- to postintervention, significant gains in IQ and Vineland Communication domain standard scores as well as a reduction in ASD severity were achieved (all P< .01). Between T2 and T3, the 6-month period immediately after completion of the intervention, IQ and Communication scores stabilized and ASD severity increased significantly {P < .05). During the long-term follow-up period (T3-T4), IQ and Communication scores significantly increased again, but ASD severity increased significantly as well (all P < .05). For overall trajectory (T1-T4), robust gains were observed for both IQ and communication; ASD severity did not change. CONCLUSIONS: Findings highlight the potential for positive long-term outcomes in toddlers with ASD. Additional research is needed to understand the relation between early exposure to uninterrupted intervention and developmental gains, and whether initial reduction in ASD symptom severity can be sustained through targeted intervention. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASDs) are the most common pediatric diagnoses in the United States. In this perspective article, we propose that a diverse set of motor impairments are present in children and adults with ASDs. Specifically, we will discuss evidence related to gross motor, fine motor, postural control, and imitation/ praxis impairments. Moreover, we propose that early motor delays within the first 2 years of life may contribute to the social impairments of children with ASDs; therefore, it is important to address motor impairments through timely assessments and effective interventions. Lastly, we acknowledge the limitations of the evidence currently available and suggest clinical implications for motor assessment and interventions in children with ASDs. In terms of assessment, we believe that comprehensive motor evaluations are warranted for children with ASDs and infants at risk for ASDs. In terms of interventions, there is an urgent need to develop novel embodied interventions grounded in movement and motor learning principles for children with autism. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASDs) are a class of neurodevelopmental disorders defined by qualitative impairments in social functioning and communication, often accompanied by repetitive and stereotyped patterns of behavior and interests. The term 'ASD' encompasses autism, pervasive developmental disorder not otherwise specified, and Asperger's syndrome. ASDs show etiologic heterogeneity, and there is no definitive medical test or cure for these conditions. Around 1 in 150 children have an ASD, with males being affected three to four times more frequently than females. The age at diagnosis of ASD ranges from 3 to 6 years, but there is increasing evidence that diagnosis in the second year of life is possible in some children. Early diagnosis will lead to earlier behavior-based intervention, which is associated with improvements in core areas, such as social functioning and communication. Early detection of—and intervention to treat—ASD is crucial because it is likely to lead to an improved outcome. [ABSTRACT FROM AUTHOR]

The current article describes the Remote Infant Studies of Early Learning, a battery intended to provide robust looking time measures of cognitive development that can be administered remotely to inform our understanding of individual developmental trajectories in typical and atypical populations, particularly infant siblings of autistic children. This battery was developed to inform our understanding of early cognitive and language development in infants who will later receive a diagnosis of autism. Using tasks that have been successfully implemented in lab-based paradigms, we included assessments of attention, memory, prediction, word recognition, numeracy, multimodal processing, and social evaluation. This study reports results on the feasibility and validity of administration of this task battery in 55 infants who were recruited from the general population at age 6 months (n = 29; 14 female, 15 male) or 12 months (n = 26; 14 female, 12 male; 62% White, 13% Asian, 1% Black, 1% Pacific Islander, 22% more than one race; 6% Hispanic). Infant looking behavior was recorded during at-home administration of the battery on the family's home computer and automatically coded for attention to stimuli using iCatcher+, an open-access software that assesses infant gaze direction. Results indicate that while some tasks replicated lab-based findings (attention, memory, prediction, and numeracy), others did not (word recognition, multimodal processing, and social evaluation). These findings will inform efforts to refine the battery as we continue to develop a robust set of tasks to improve the understanding of early cognitive development at the individual level in general and clinical populations. Public Significance Statement: We present pilot data from the first instantiation of the Remote Infant Studies of Early Learning Battery that was designed to assess infant cognitive development remotely. Findings show results consistent with preregistration for some (attention, memory, prediction, and numeracy) but not all tasks. These results will inform the continued development of a remote battery for the assessment of cognitive development in general and clinical populations. [ABSTRACT FROM AUTHOR]