Abstract
To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children’s development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID) were identified. At 6 months, associations between early signs and ASD or ID were found only in few areas. At 18 months social, language, and motor skills were delayed, and suspicion of vision and hearing problems were increased for both groups. Signs distinguishing ASD from ID were unclear, and the positive predictive values regarding ASD were below 10 % for individual predictors and aggregated risk scores.
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Baghdadli, A., Picot, M. C., Pascal, C., Pry, R., & Aussilloux, C. (2003). Relationship between age of recognition of first disturbances and severity in young children with autism. European Child and Adolescent Psychiatry, 12, 122–127.
Bolton, P. F., Golding, J., Emond, A., & Steer, C. D. (2012). Autism spectrum disorder and autistic traits in the avon longitudinal study of parents and children: Precursors and early signs. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 249–260.
Bryson, S., Zwaigenbaum, L., Brian, J., Roberts, W., Szatmari, P., Rombough, V., et al. (2007). A prospective case series of high-risk infants who developed autism. Journal of Autism and Developmental Disorders, 37, 12–24.
Chakrabarti, S., & Fombonne, E. (2005). Pervasive developmental disorders in preschool children: Confirmation of high prevalence. American Journal of Psychiatry, 162, 1133–1141.
Chawarska, K., Paul, R., Klin, A., Hannigen, S., Dichtel, L. E., & Volkmar, F. (2007). Parental recognition of developmental problems in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 62–72.
Clifford, S., Young, R., & Williamson, P. (2007). Assessing the early characteristics of autistic disorder using video analysis. Journal of Autism and Developmental Disorders, 37, 301–313.
Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775–803.
De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Child and Adolescent Psychiatry, 7, 131–136.
DNBC. (2012). Danish National Birth Cohort. Retrieved from http://www.ssi.dk/English/RandD/Research%20areas/Epidemiology/DNBC/For%20researchers/Data%20available.aspx. Accessed 28 Jan 2013.
Esposito, G., & Venuti, P. (2008). Analysis of toddlers’ gait after six months of independent walking to identify autism: A preliminary study. Perceptual and Motor Skills, 106, 259–269.
Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. [Review]. Pediatric Research, 65, 591–598.
Kalbfleisch, J. D., & Prentice, R. L. (2002). The statistical analysis of failure time data (2nd ed.). New York: Wiley.
Kim, J. (2012). Survival analysis. Pediatrics in Review, 33, 172–174.
Kirkwood, B., & Sterne, J. (2003). Essential medical statistics (2nd ed.). Oxford: Blackwell Science.
Landa, R., & Garrett-Mayer, E. (2006). Development in infants with autism spectrum disorders: A prospective study. Journal of Child Psychology and Psychiatry, 47, 629–638.
Landa, R. J. (2008). Diagnosis of autism spectrum disorders in the first 3 years of life. Nature Clinical Practice Neurology, 4, 138–147.
Lauritsen, M. B., Jorgensen, M., Madsen, K. M., Lemcke, S., Toft, S., Grove, J., et al. (2010). Validity of childhood autism in the Danish Psychiatric Central Register: Findings from a cohort sample born 1990–1999. Journal of Autism and Developmental Disorders, 40, 139–148.
Lloyd, M., Macdonald, M., & Lord, C. (2011). Motor skills of toddlers with autism spectrum disorders. Autism. doi:10.1177/1362361311402230.
Lynge, E., Sandegaard, J. L., & Rebolj, M. (2011). The Danish National Patient Register. Scandinavian Journal of Public Health, 39, 30–33.
Mors, O., Perto, G. P., & Mortensen, P. B. (2011). The Danish Psychiatric Central Research Register. Scandinavian Journal of Public Health, 39, 54–57.
Nohr, E. A., Frydenberg, M., Henriksen, T. B., & Olsen, J. (2006). Does low participation in cohort studies induce bias? Epidemiology, 17, 413–418.
Olsen, J., Melbye, M., Olsen, S. F., Sorensen, T. I., Aaby, P., Andersen, A. M., et al. (2001). The Danish National Birth Cohort-its background, structure and aim. Scandinavian Journal of Public Health, 29, 300–307.
Osterling, J. A., Dawson, G., & Munson, J. A. (2002). Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation. Development and Psychopathology, 14, 239–251.
Ozonoff, S., Iosif, A. M., Baguio, F., Cook, I. C., Hill, M. M., Hutman, T., et al. (2010). A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 256–266.
Ozonoff, S., Young, G. S., Goldring, S., Greiss-Hess, L., Herrera, A. M., Steele, J., et al. (2008). Gross motor development, movement abnormalities, and early identification of autism. Journal of Autism and Developmental Disorders, 38, 644–656.
Palomo, R., Belinchon, M., & Ozonoff, S. (2006). Autism and family home movies: A comprehensive review. Journal of Developmental and Behavioral Pediatrics, 27, S59–S68.
Parner, E. T., Schendel, D. E., & Thorsen, P. (2008). Autism prevalence trends over time in Denmark: Changes in prevalence and age at diagnosis. Archives of Pediatrics Adolescent Medicine, 162, 1150–1156.
Pedersen, C. B., Gotzsche, H., Moller, J. O., & Mortensen, P. B. (2006). The Danish Civil Registration System. A cohort of eight million persons. Danish Medical Bulletin, 53, 441–449.
Petersen, D., Bilenberg, N., Hoerder, K., & Gillberg, C. (2006). The population prevalence of child psychiatric disorders in Danish 8 to 9 year old children. European Child and Adolescent Psychiatry, 15, 71–78.
Sivberg, B. (2003). Parents’ detection of early signs in their children having an autistic spectrum disorder. Journal of Pediatric Nursing, 18, 433–439.
Vostanis, P., Smith, B., Corbett, J., Sungum-Paliwal, R., Edwards, A., Gingell, K., et al. (1998). Parental concerns of early development in children with autism and related disorders. Autism: International journal of research, 2, 229–242.
Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-Vanderweele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127, e1303–e1311.
Watson, L. R., Baranek, G. T., Crais, E. R., Steven, R. J., Dykstra, J., & Perryman, T. (2007). The first year inventory: retrospective parent responses to a questionnaire designed to identify one-year-olds at risk for autism. Journal of Autism and Developmental Disorders, 37, 49–61.
Werner, E., & Dawson, G. (2005). Validation of the phenomenon of autistic regression using home videotapes. Archives of General Psychiatry, 62, 889–895.
Werner, E., Dawson, G., Munson, J., & Osterling, J. (2005). Variation in early developmental course in autism and its relation with behavioral outcome at 3–4 years of age. Journal of Autism and Developmental Disorders, 35, 337–350.
Wetherby, A. M., Watt, N., Morgan, L., & Shumway, S. (2007). Social communication profiles of children with autism spectrum disorders late in the second year of life. Journal of Autism and Developmental Disorders, 37, 960–975.
Wiggins, L. D., Baio, J., & Rice, C. (2006). Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample. Journal of Developmental and Behavioral Pediatrics, 27, S79–S87.
Wiggins, L. D., Rice, C. E., & Baio, J. (2009). Developmental regression in children with an autism spectrum disorder identified by a population-based surveillance system. Autism, 13, 357–374.
Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003). Prevalence of autism in a US metropolitan area. The journal of the American Medical Association, 289, 49–55.
Yirmiya, N., & Charman, T. (2010). The prodrome of autism: early behavioral and biological signs, regression, peri- and post-natal development and genetics. Journal of Child Psychology and Psychiatry, 51, 432–458.
Young, R. L., Brewer, N., & Pattison, C. (2003). Parental identification of early behavioural abnormalities in children with autistic disorder. Autism, 7, 125–143.
Acknowledgments
This study was funded by grants from The Danish Medical Research Council, The Elsass Foundation, The Tryg Foundation and The Beatrice Surovell Haskell Fund for Child Mental Health Research of Copenhagen. The Danish National Research Foundation has established the Danish Epidemiology Science Centre that initiated and created the Danish National Birth Cohort. The cohort is furthermore a result of a major grant from this Foundation. Additional support for the Danish National Birth Cohort is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Insurance Foundation.
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Lemcke, S., Juul, S., Parner, E.T. et al. Early Signs of Autism in Toddlers: A Follow-Up Study in the Danish National Birth Cohort. J Autism Dev Disord 43, 2366–2375 (2013). https://doi.org/10.1007/s10803-013-1785-z
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DOI: https://doi.org/10.1007/s10803-013-1785-z