The aim of the study was to identify early behavioural abnormalities in children later diagnosed with autistic disorder. Accurate identification of such deficits has implications for early diagnosis, intervention and prognosis. The parents of 153 children with autistic disorder completed a questionnaire asking them to describe early childhood behaviours of concern and to recall the age of onset. Core deficit-linked behaviours were then identified and the ontogeny of their development was noted. Behaviour categories were: (1) gross motor difficulties, (2) social awareness and play deficits, (3) language and communication difficulties, and (4) unusual preoccupations. The findings supported the notion that the nature and prevalence of these deficits depend on age. Consistent with past research, there was a significant interval between parents first noticing abnormalities and the making of a definitive diagnosis. The implications for this delay are discussed.
Get full access to this article
View all access options for this article.
References
1.
ADRIEN, J.L., FAIRE, M., PERROT, A., HUMERI, L., GARREAU, B., BARTHELEMY, C. & SAUVAGE, D. (1991) ‘Autism and Family Home Movies: Preliminary Findings’ , Journal of Autism and Developmental Disorders21: 42-49 .
2.
ADRIEN, J.L., LENOIR, P., MARTINEAU, J., PERROT, A., HAMEURY, L., LARMANDE, C. & SAUVAGE, D. (1993) ‘Blind Ratings of Early Symptoms of Autism Based upon Family Home Movies’ , Journal of the American Academy of Child and Adolescent Psychiatry32: 617-627 .
3.
AMERICAN PSYCHIATRIC ASSOCIATION (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). Washington, DC: APA .
4.
AMERICAN PSYCHIATRIC ASSOCIATION (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edn text revision (DSM-IV-TR). Washington, DC: APA .
5.
BAILEY, A., PHILLIPS, W. & RUTTER, M. (1996) ‘Autism: Towards an Integration of Clinical, Genetic, Neuropsychological, and Neurobiological Perspectives’ , Journal of Child Psychology and Psychiatry37: 89-126 .
6.
BAIRD, G., CHARMAN, T., BARON-COHEN, S., COX, A., SWETTENHAM, J., WHEELRIGHT, S. & DREW, A. (2000) ‘A Screening Instrument for Autism at 18 Months of Age: A Six-Year Follow-Up Study’ , Journal of the American Academy of Child and Adolescent Psychiatry39: 694-702 .
7.
BARANEK, G.T. (1999) ‘Autism during Infancy: A Retrospective Video Analysis of Sensory-Motor and Social Behaviours at 9-12 Months of Age’ , Journal of Autism and Developmental Disorders29: 213-224 .
8.
BARON-COHEN, S., ALLEN, J. & GILLBERG, C. (1992) ‘Can Autism Be Detected at 18 Months? The Needle, the Haystack and the CHAT’ , British Journal of Psychiatry161: 839-843 .
9.
BARON-COHEN, S., COX, A., BAIRD, G., SWETTENHAM, J., NIGHTINGALE, N., MORGAN, K., DREW, A. & CHARMAN, T. (1996) ‘Psychological Markers in the Detection of Autism in Infancy in a Large Population’ , The British Journal of Psychiatry168: 158-163 .
10.
BATES, E. (1979) The Emergence of Symbols: Cognition and Communication in Infancy. New York: Academic .
11.
BERNABEI, P. & CAMAIONI, L. (2001) ‘Developmental Profile and Regression in a Child with Autism: A Single Case Study’ , Autism5: 287-297 .
12.
BRYSON, S.E. (1996) ‘Brief Report: Epidemiology of Autism’ , Journal of Autism and Developmental Disorders26: 165-167 .
13.
BRYSON, S.E. & SMITH, I.M. (1998) ‘Epidemiology of Autism: Prevalence, Associated Characteristics, and Implications for Research and Service Delivery’ , Mental Retardation and Developmental Disabilities Research Reviews4: 97-103 .
14.
CARPENTER, M., NAGELL, K. & TOMASELLO, M. (1998) ‘Social Cognition, Joint Attention, and Communicative Competence from 9 to 15 Months of Age’ , Monographs for the Society of Research in Child Development63: 1-176 .
15.
CHARMAN, T., SWETTENHAM, J., BARON-COHEN, S., COX, A., BAIRD, G. & DREW, A. (1998) ‘An Experimental Investigation of Social-Cognitive Abilities in Infants with Autism: Clinical Implications’ , Infant Mental Health Journal19: 260-275 .
16.
CHUNG, M.C., SMITH, B. & VOSTANIS, P. (1995) ‘Detection of Children with Autism’ , Educational and Child Psychology12: 31-36 .
17.
COX, A., KLEIN, K., CHARMAN, T., BAIRD, G., BARON-COHEN, S., SWETTENHAM, J., DREW, A., WHEELWRIGHT, S. & NIGHTINGALE, N. (1999) ‘Autism Spectrum Disorders at 20 and 42 Months of Age: Stability of Clinical and ADI-R Diagnosis’ , Journal of Child Psychology and Psychiatry and Allied Disciplines40: 719-732 .
18.
DAHLGREN, S.O. & GILLBERG, C. (1989) ‘Symptoms in the First Two Years of Life: A Preliminary Population Study of Infantile Autism’ , European Archives of Psychiatry and Neurological Sciences238: 169-174 .
19.
DAVIDOVITCH, M., GLICK, L., HOLTZMAN, G., TIROSH, E. & SAFIR, M. (2000) ‘Developmental Regression in Autism: Maternal Perception’ , Journal of Autism and Developmental Disorders30: 113-119 .
20.
DE GIACOMO, A. & FOMBONNE, E. (1998) ‘Parental Recognition of Developmental Abnormalities in Autism’ , European Child and Adolescent Psychiatry7: 131-136 .
21.
DEMYER, M.K., HINGTGEN, J.N. & JACKSON, R.K. (1981) ‘Infantile Autism Reviewed: A Decade of Research’ , Schizophrenia Bulletin7: 388-451 .
22.
DESROCHERS, S., MORISSETTE, P. & RICARD, M. (1995) ‘Two Perspectives on Pointing in Infancy’, in C. MOORE & P. DUNHAM (eds) Joint Attention: Its Origins and Role in Development, pp. 85-101. Hillsdale, NJ: Erlbaum .
23.
ERIKSSON, A. & DE-CHATEAU, P. (1992) ‘Brief Report: A Girl Aged Two Years and Seven Months with Autistic Disorder Videotaped’ , Journal of Autism and Developmental Disorders22: 127-129 .
24.
FRITH, U. & SOARES, I. (1993) ‘Research into Earliest Detectable Signs of Autism: What the Parents Say’ , Communication27: 17-18 .
25.
GHAZIUDDIN, M., TSAI, L. & GHAZIUDDIN, N. (1992) ‘Comorbidity of Autistic Disorder in Children and Adolescents’ , European Child and Adolescent Psychiatry1: 209-213 .
26.
GHAZIUDDIN, M., BUTLER, E., TSAI, L. & GHAZIUDDIN, N. (1994) ‘Is Clumsiness a Marker for Asperger Syndrome?’ , Journal of Intellectual Disability Research38: 519-527 .
27.
GILLBERG, C. (ed.) (1989) Diagnosis and Treatment of Autism. New York: Plenum .
28.
GILLBERG, C., EHLERS, S., SCHAUMANN, H., JAKOBSSON, G., DAHLGREN, S.O., LINDBLOM, R.ET AL. (1990) ‘Autism under Age 3 Years: A Clinical Study of 28 Cases Referred for Autistic Symptoms in Infancy’ , Journal of Child Psychology and Psychiatry31: 921-934 .
29.
GILLBERG, C., NORDIN, V. & EHLERS, S. (1996) ‘Early Detection of Autism: Diagnostic Instruments for Clinicians’ , European Child and Adolescent Psychiatry5: 67-74 .
30.
GRAY, K.M. & TONGE, B.J. (2001) ‘Are There Early Features of Autism in Infants and Preschool Children?’ , Journal of Paediatrics and Child Health37: 221-226 .
31.
HOWLIN, P. & ASGHARIAN, A. (1999) ‘The Diagnosis of Autism and Asperger Syndrome: Findings from a Survey of 770 Families’ , Developmental Medicine and Child Neurology41: 834-839 .
32.
HOWLIN, P. & MOORE, A. (1997) ‘Diagnosis of Autism: A Survey of over 1200 Patients in the UK’ , Autism1: 135-162 .
33.
JOHNSON, M.H., SIDDONS, F., FRITH, U. & MORTON, J. (1992) ‘Can Autism Be Predicted on the Basis of Infant Screening Tests?’ , Developmental Medicine and Child Neurology34: 316-320 .
34.
KANNER, L. (1943) ‘Autistic Disturbances of Affective Contact’ , Nervous Child2: 17-250 .
35.
KANNER, L. (1971) ‘Follow-Up Study of Eleven Autistic Children Originally Reported in 1943’ , Journal of Autism and Childhood Schizophrenia1: 119-145 .
36.
KLIN, A., LANG, J., CICCHETTI, D.V. & VOLKMAR, F.R. (2000) ‘Brief Report: Interrater Reliability of Clinical Diagnosis and DSM-IV Criteria for Autistic Disorder: Results of the DSM-IV Autism Field Study’ , Journal of Autism and Developmental Disorders30: 163-167 .
37.
LORD, C. (1995) ‘Follow-Up of Two-Year-Olds Referred for Possible Autism’ , Journal of Child Psychology and Psychiatry36: 1365-1382 .
38.
LORD, C. & PICKLES, A. (1996) ‘Language Level and Nonverbal Social- Communicative Behaviours in Autistic and Language Delayed Children’ , Journal of the American Academy of Child and Adolescent Psychiatry35: 1542-1550 .
39.
LORD, C., STOROSCHUK, S., RUTTER, M. & PICKLES, A. (1993) ‘Using the ADI-R to Diagnose Autism in Preschool Children’ , Infant Mental Health Journal14: 234-252 .
40.
LORD, C., PICKLES, A., MCLENNAN, J., RUTTER, M., BREGMAN, M, FOLSTEIN, S., FOMBONNE, E., LEBOYER, M. & MINSHEW, N. (1997) ‘Diagnosis of Autism: Analyses of Data from the Autism Diagnostic Review’ , Journal of Autism and Developmental Disorders27: 501-517 .
41.
LOVELAND, K.A. & LANDRY, S.H. (1986) ‘Joint Attention and Language in Autism and Developmental Delay’ , Journal of Autism and Developmental Disorders16: 335-349 .
42.
LYYTINEN, P. (1991) ‘Peer Interaction in Children’s Dyadic Play’ , Early Child Development and Care71: 105-115 .
43.
MAESTRO, S., MURATORI, F., BARBIERI, F., CASELLA, C., CATTANEO, V., CAVALLARO, M., CESARI, A., MILONE, A., RIZZO, L., VIGLIONE, V., STERN, D. & PALACIO-ESPASA, F. (2001) ‘Early Behavioural Development in Autistic Children: The First 2 Years of Life through Home Movies’ , Psychopathology34: 147-152 .
44.
MARS, A.E., MAUK, J.E. & DOWRICK, P. (1998) ‘Symptoms of Pervasive Developmental Disorders as Observed in Prediagnostic Home Videos of Infants and Toddlers’ , Journal of Pediatrics132: 500-504 .
45.
MINSHEW, N.J., JOHNSON, C. & LUNA, B. (2001) ‘The Cognitive and Neural Basis of Autism: A Disorder of Complex Information Processing and Dysfunction of Neocortical Systems’, in L.M. GLIDDEN (ed.) International Review of Research in Mental Retardation. Vol.23: Autism, pp. 111-138. San Diego, CA: Academic .
46.
MUNDY, P. (1995) ‘Joint Attention, Social-Emotional Approach in Children with Autism’ , Development and Psychopathology7: 63-82 .
47.
MUNDY, P. & CROWSON, M. (1997) ‘Joint Attention and Early Communication: Implications for Intervention with Autism’ , Journal of Autism and Developmental Disorders27: 653-676 .
48.
MUNDY, P. & MARKUS, J. (1997) ‘On the Nature of Communication and Language Impairment in Autism’ , Mental Retardation and Developmental Disabilities Reviews3: 343-349 .
49.
MUNDY, P. & SIGMAN, M. (1989a) ‘Specifying the Nature of the Social Impairment in Autism’, in G. DAWSON (ed.) Autism, pp. 3-21. New York: Guilford .
50.
MUNDY, P. & SIGMAN, M. (1989b) ‘The Theoretical Implications of Joint Attention Deficits in Autism’ , Development and Psychopathology1: 173-183 .
51.
MUNDY, P., SIGMAN, M., UNGERER, J. & SHERMAN, T. (1986) ‘Defining the Social Deficits of Autism: The Contribution of Nonverbal Communication Measures’ , Journal of Child Psychology and Psychiatry27: 657-669 .
52.
MUNDY, P., SIGMAN, M. & KASARI, C. (1993) ‘The Theory of Mind and Joint Attention Deficits in Autism’, in S. BARON-COHEN, H. TAGER-FLUSBERG & D. COHEN (eds) Understanding Other Minds: Perspectives from Autism, pp. 181-203. Oxford: Oxford University Press .
53.
OHTA, M., NAGAI, Y., HARA, H. & SASAKI, M. (1987) ‘Parental Perception of Behavioural Symptoms in Japanese Autistic Children’ , Journal of Autism and Developmental Disorders17: 549-563 .
54.
ORNITZ, E.M., GUTHRIE, D. & FARLEY, A.H. (1977) ‘The Early Development of Autistic Children’ , Journal of Autism and Childhood Schizophrenia7: 207-229 .
55.
OSTERLING, J. & DAWSON, G. (1994) ‘Early Recognition of Children with Autism: A Study of First Birthday Home Videotapes’ , Journal of Autism and Developmental Disorders24: 247-257 .
56.
PRIZANT, B.M. & WETHERBY, A.M. (1988) ‘Providing Services to Children with Autism (Ages 0 to 2 Years) and Their Families’ , Topics in Language Disorders9: 1-23 .
57.
RASPIN, I. (1997) ‘Autism’ , The New England Journal of Medicine337: 97-104 .
58.
RUTTER, M. & SCHOPLER, E. (1992) ‘Classification of Pervasive Developmental Disorders: Some Concepts and Practical Considerations’ , Journal of Autism and Developmental Disorders22: 459-482 .
59.
RUTTER, M., GREENFIELD, D. & LOCKYER, L. (1967) ‘A Five to Fifteen Year Follow-Up Study of Infantile Psychosis. II: Social and Behavioural Outcome’ , British Journal of Psychiatry113: 1183-1199 .
60.
RUTTER, M., SILBERG, J., O’CONNOR, T. & SIMONOFF, E. (1999) ‘Genetics and Child Psychiatry. II: Empirical Research Findings’ , Journal of Child Psychology, Psychiatry and Allied Disciplines40: 19-55 .
61.
SCHOPLER, E., REICHLER, R.J. & RENNER, B.R. (1988) The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services .
62.
SHORT, A.B. & SCHOPLER, E. (1988) ‘Factors Relating to Age of Onset in Autism’ , Journal of Autism and Developmental Disorders18: 207-216 .
63.
SIEGEL, B., PLINER, C., ESCHLER, J. & ELLIOT, G.R. (1988) ‘How Children with Autism Are Diagnosed: Difficulties in Identification of Children with Multiple Developmental Delays’ , Journal of Developmental and Behavioural Paediatrics9: 199-204 .
64.
SMITH, B., CHUNG, M.C. & VOSTANIS, P. (1994) ‘The Path to Care in Autism: Is It Better Now?’ , Journal of Autism and Developmental Disorders24: 551-563 .
65.
SPARLING, J.W. (1991) ‘A Prospective Case Report of Infantile Autism from Pregnancy to Four Years’ , Journal of Autism and Developmental Disorders21: 229-236 .
66.
STONE, W.L., LEE, E.B., ASHFORD, L., BRISSIE, J., HEPBURN, S.L., COONROD, E.E. & WEISS, B.H. (1999) ‘Can Autism Be Diagnosed Accurately in Children under Three Years?’ , Journal of Child Psychology and Psychiatry40: 219-226 .
67.
VOLKMAR, F.R. (1998) ‘Categorical Approaches to the Diagnosis of Autism: An Overview of DSM-IV and ICD-10’ , Autism2: 45-59 .
68.
VOLKMAR, F.R., STIER, D.M. & COHEN, D.J. (1985) ‘Age of Recognition of Pervasive Developmental Disorder’ , American Journal of Psychiatry142: 1450-1452 .
69.
VOLKMAR, F.R., KLIN, A. & COHEN, D.J. (1997) ‘Diagnosis and Classification of Autism and Related Conditions: Consensus and Issues’, in D.J. COHEN & F.R. VOLKMAR (eds) Handbook of Autism and Pervasive Developmental Disorders, 2nd edn, pp. 5-40. New York: Wiley .
70.
VOSTANIS, P., SMITH, B., CORBETT, J., SUNGUM, P.R., EDWARDS, A., GINGELL, K., GOLDING, R., MOORE, A. & WILLIAMS, J. (1998) ‘Parental Concerns of Early Development in Children with Autism and Related Disorders’ , Autism2: 229-242 .
71.
WERNER, E., DAWSON, G., OSTERLING, J. & DINNO, N. (2000) ‘Brief Report: Recognition of Autism Spectrum Disorder before One Year of Age: A Retrospective Study Based on Home Videotapes’ , Journal of Autism and Developmental Disorders30: 157-162 .
