A review of: S. Ozonoff, S. Macari, G. S. Young, S. Goldring, M. Thompson, S. J. Rogers (2008). Atypical object exploration at 12 months of age is associated with autism in a prospective sample Autism, 12 (5), 457-472 DOI: 10.1177/1362361308096402

A number of research programs are currently examining very early signs of autism. Researchers believe that if they are able to identify behaviors or symptoms that reliably predict the development of autism, these kids could receive early intervention and we may be able to better understand how autism emerges during key developmental periods. I have reviewed some of these studies (see for example this review of a study of infancy motor asymmetry and autism). The current study comes to us from the MIND institute at the University of California at Davis. The researchers wanted to examine atypical use of objects during infancy (12 month of age) and explore whether object use during this time predicted the development of autism 1 to 2 years later.

The sample included a high-risk group consisting of 35 non-affected siblings of children with autism and 31 siblings of typically developing kids. 62% of the sample were males. All children were 12 month of age at the time of the first assessment. These children were further evaluated at 24 or 36 month of age via a comprehensive neurodevelopmental battery of tests which included the ADOS.

At 12 months of age, the infants were observed interacting with 4 objects (metal lid, plastic ring, rattle, baby bottle). The interactions lasted 30-seconds each. These interactions were coded for typical and atypical object use. Typical uses at this age would include shaking, banging, mouthing, and throwing. More infrequent, and thus atypical, uses of these toys would include spinning, rolling, rotating, and unusual visual exploration (looking at the toy from odd angles or peripherally).

From the initial pool of 66 infants, 9 eventually met diagnostic criteria for autism (based on ADOS), 10 met criteria for non-asd developmental delay, 47 did not receive any diagnosis (no concern group). There were no differences among these 3 outcome groups in regards to gestational age, ethnicity, or income. However, the percentage of males in the autism group (100%) was significantly higher than in the developmental delay (70% males) and the no concern group (49% males).

In regards to typical object use, the only group difference observed was for “throwing”. Infants who would eventually be classified into the developmental delayed group were significantly more likely to throw the objects than children eventually classified into the autism or no concern groups. However, in regards to atypical object use, the findings were striking. Infants who would eventually developed autism were significantly more likely to engage in all 4 atypical uses (spinning, rolling, rotating, and unusual visual exploration) than kids classified into the no concerns group. In addition, 3 specific atypical object behaviors differentiated kids with autism from those who would develop a non-asd developmental delay. Specifically, kids with autism were more likely to spin, rotate, or engage in atypical visual inspection of the objects, than developmentally delayed kids.

These results indicate that, among children at familial risk for autism, atypical object use during infancy seems to be associated with autism diagnosis during early childhood. Furthermore, this effect appears to be specific to austim –and not to general developmental delays.


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3 Responses to Atypical play behaviors in infancy predict autism diagnosis

  1. leila says:

    My autistic son didn’t display those atypical ways of playing with toys. The only weird thing at 12 months is that he was more interested in the street signs than looking at squirrels, birds and dogs when we went out walking. Those atypical toy manipulation behaviors only appeared at about 15 months (lining up toys) and then another one at 4 years old (looking at objects up close laying on the floor). I very much enjoy the research on early recognition, but there’s still a lot that they use as red flags/markers that my son did not have at 12 months (such as not responding to name). In my son’s case the earliest symptom was not pointing at 12 months.

  2. soozin says:

    This is fascinating, and the first time I’ve seen “unusual visual exploration” mentioned.

    My son (now 3, diagnosed PDD-NOS at 2.5 years of age) definitely exhibited the “unusual visual exploration” of objects before 12 months. He would stare at the pattern on the carpet created by sunlight coming through a basket, often quite intensely, and seemed to remember to look for this pattern at certain times of day (when the sun would be due to shine through that particular window). He never got into spinning objects, but would turn them over and over in his hands and examine every angle. To this day his favorite toys have doors and windows that he can peer through, turn upside down, and drop other objects through, to see where they end up. Doors are a particular fascination, especially elevator or other mechanical doors.

    On a somewhat unrelated note, he refused to play with any type of doll or humanistic figure, e.g. the “Little People” people, always preferring animal figures or inanimate objects, doors, houses, etc.

  3. TheFiveDays says:

    My son has participated in research at MIND with some of these investigators. We brought him in to see Drs. Ozonoff & Rogers when he was 12 months old and after observing him they said that although they couldn't diagnose him yet, they would have been very surprised if he didn't end up with autism.

    One of the things he did at his initial observation with them was to spin a metal lid over and over.

    He also was fascinated with spinning everything at home. Any object you gave him was first inspected to see if it could be spun!

    He also displayed some of the "unusual visual exploration" and that's still a tough one for us to stop (he is now 5).

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