Jessica R Shoaff1,2, Kevin Nugent3,4, Thomas Berry Brazelton3,4, Susan A Korrick1,5. 1. Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 3. Division of Developmental Medicine, Brazelton Institute, Boston Children's Hospital, Boston, MA, USA. 4. Harvard Medical School, Boston, MA, USA. 5. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder typically diagnosed after the second year of life; however, differences in brain structure and function associated with ASD have been ascertained in early infancy. Identifying behavioural markers of ASD risk in early infancy has the potential to facilitate early detection and intervention. OBJECTIVES: We examined associations between infant behaviour and adolescent behaviours associated with ASD. METHODS: Analyses leveraged data available on 370 participants from the New Bedford Cohort, a sociodemographically diverse prospective birth cohort of children born from 1993 to 1998 to mothers residing near the New Bedford Harbor Superfund site in Massachusetts. Longitudinal assessments were used to examine the associations between behaviours when children were approximately 2 weeks old (measured by the Neonatal Behavioral Assessment Scale [NBAS]), and subsequent maladaptive behaviours associated with ASD at approximately 15 years old [measured by the Behavior Assessment System for Children, 2nd Edition-Teacher Rating Scale (BASC-2 TRS) scores which are standardised to a mean (SD) of 50 (10)]. RESULTS: Poorer performance on select individual items and cluster scales of the NBAS was associated with an increase in behaviours associated with ASD in adolescents. Associations were strongest for neonatal measures of self-regulation, response to auditory input, and autonomic nervous system regulation. For example, in covariate-adjusted models, infants with Regulation of State NBAS cluster scores in the lowest tertile (poorest performance) compared to infants with scores in the higher two tertiles had adolescent BASC-2 TRS Developmental Social Disorders T-scores that were 2.9 points higher (95% CI: 0.8, 4.9), indicating more behaviours associated with ASD. CONCLUSION: The NBAS is an established and accessible instrument that assesses a broad range of behaviours in very young infants, and may be a useful tool for newborn assessments of developmental risk, including risk of ASD-associated behaviours.
BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder typically diagnosed after the second year of life; however, differences in brain structure and function associated with ASD have been ascertained in early infancy. Identifying behavioural markers of ASD risk in early infancy has the potential to facilitate early detection and intervention. OBJECTIVES: We examined associations between infant behaviour and adolescent behaviours associated with ASD. METHODS: Analyses leveraged data available on 370 participants from the New Bedford Cohort, a sociodemographically diverse prospective birth cohort of children born from 1993 to 1998 to mothers residing near the New Bedford Harbor Superfund site in Massachusetts. Longitudinal assessments were used to examine the associations between behaviours when children were approximately 2 weeks old (measured by the Neonatal Behavioral Assessment Scale [NBAS]), and subsequent maladaptive behaviours associated with ASD at approximately 15 years old [measured by the Behavior Assessment System for Children, 2nd Edition-Teacher Rating Scale (BASC-2 TRS) scores which are standardised to a mean (SD) of 50 (10)]. RESULTS: Poorer performance on select individual items and cluster scales of the NBAS was associated with an increase in behaviours associated with ASD in adolescents. Associations were strongest for neonatal measures of self-regulation, response to auditory input, and autonomic nervous system regulation. For example, in covariate-adjusted models, infants with Regulation of State NBAS cluster scores in the lowest tertile (poorest performance) compared to infants with scores in the higher two tertiles had adolescent BASC-2 TRS Developmental Social Disorders T-scores that were 2.9 points higher (95% CI: 0.8, 4.9), indicating more behaviours associated with ASD. CONCLUSION: The NBAS is an established and accessible instrument that assesses a broad range of behaviours in very young infants, and may be a useful tool for newborn assessments of developmental risk, including risk of ASD-associated behaviours.
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