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Observational Study
. 2024 Jul 1;78(4):7804185050.
doi: 10.5014/ajot.2024.050438.

Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder

Joanne E Flanagan  1 , Barbara B Demchick  2 , Rebecca Landa  3 , Janet V Delany  4 , Gustavo Reinoso  5
Affiliations
Observational Study

Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder

Joanne E Flanagan et al. Am J Occup Ther. .

Abstract

Importance: Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis.

Objective: To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns.

Design: Observational cohort longitudinal design using blinded video analysis.

Participants: Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age.

Results: Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD.

Conclusions and relevance: Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.

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Figures

Figure 1.
Figure 1.
Distribution of infant play scores for the ASD, EL non-ASD, and TL non-ASD groups. Note. Boxes represent the interquartile range with the median indicated by a central line. Whiskers extend to the highest and lowest values. ASD = autism spectrum disorder, EL = elevated likelihood, TL = typical likelihood.
See this image and copyright information in PMC

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