Neonatal neurobehavior in infants with autism spectrum disorder

Abstract

Aim: To investigate neurobehavioral maturation for neonates who are later diagnosed with autism spectrum disorder (ASD).

Method: In a prospective longitudinal design, neonatal neurobehavior was examined monthly in 1- to 3-month-old infants at elevated and low familial likelihood of ASD (n=60). At 2 years, infants were seen for a clinical best-estimate evaluation, resulting in 18 infants with ASD and 36 typically developing infants. Repeated-measures analysis of variance models were conducted to examine the effects of age, diagnostic group, and their interactions.

Results: Neurobehavioral maturation of infants diagnosed with ASD was largely comparable to typically developing infants from 1 to 3 months, with the exception of the development of attention. Object-focused attention was significantly attenuated for infants with ASD beginning at 2 to 3 months and was predictive of social-communication skills 2 years later.

Interpretation: This is the first study to prospectively examine neonatal neurobehavior of infants at an elevated familial likelihood of ASD who later received a diagnosis. Despite relatively intact neurological and behavioral maturation in the neonatal period, attention to objects emerged as a key early indicator of ASD. This suggests a complex attentional vulnerability within the first 3 months of life that may be associated with cascading sequelae of social-communication challenges and the emergence of ASD.

Figure 1:

Attention scores (least-squares means) with associated standard errors for autism spectrum disorder (ASD) and typically developing infants at months 1, 2, and 3. The Tukey–Kramer adjusted p-values were used. ns, p>0.05; ^a p≤0.05; ^b p≤0.001.