Assessing the Early Characteristics of Autistic Disorder using Video Analysis

Abstract

The behaviours of infants were observed using home videos, in an attempt to identify social difficulties characteristic of infants with autistic disorder. Three groups of infants were analysed: 15 infants who had later been diagnosed with autism, 15 infants who had a developmental or language delay, and 15 typically developing infants. Social behaviours were coded using both quantitative and qualitative measures. The principal discriminating items between the groups were found to be ‘peer interest’, ‘gaze aversion’, ‘anticipatory postures’, and ‘proto-declarative showing’. The results suggest that these children later diagnosed with autism are clinically distinct from their peers before the age of two years, and that there are clearly observable behaviours which are important predictors of autistic disorder in pre-verbal children.

Appendices

Appendix A

Operational Definitions of Social Behaviours

1. Eye Contact*—The infant directs his/her visual attention to a person and looks directly into the person’s face and into the eyes; or looks directly at the camera when a person is standing behind the camera

2. Gaze aversion—The infant avoids the gaze based upon opportunities for face-to-face interactions by staring away or turning his/her head from the person/event

3. Social Smile—The infant smiles at a person, or object or event in the presence of a person. The infant responds to the smile of a caregiver by returning a smile immediately after the caregiver initiated that smile (reciprocal); or the infant smiles at person (without reciprocating the smile of another person)

4. Nestling—The infant leans into the body of a person, resting his/her head on the shoulder of the caregiver, and perhaps putting his/her arms around the caregiver

5. Anticipatory posture*—The infant leans forward towards their caregiver and/or raising one or both arms—in response to being approached by the caregiver with his/her arms stretched out to the child; Infant acts in a way that anticipates other activities such as being handed a ball

6. Social Gestures*—The infant copies a simple physical behaviour demonstrated by the caregiver, (by imitation, request or a way appropriate to the context); or the infant demonstrates spontaneous gestures such as a wave goodbye (without any obvious prompting, modeling or requesting by the caregiver)

7. Requesting Gestures—The infant points or extends arm and hand toward a desired object which aids the infant in obtaining the object (is part of a request, is often accompanied by vocalisation)

8. Social Peer interest—The infant shows interest in another child by attempting to approach the child, by demonstrating manifestations of pleasure or excitement

9. Joint Attention (gaze monitoring*)—The infant follows the care givers point or gaze by moving their head/focus or turning in the same direction in which the caregiver is looking, pointing, or showing interest (attention to a common focus)

10. Joint Attention (Proto-declarative showing)—The infant brings an object to a person or extends arm in the direction of the person’s face to show the object to the caregiver for the purposes of sharing

11. Joint Attention (Proto-declarative pointing)—The infant points at an object in order to direct the caregiver’s attention to the object to share interest in the object

12. Responding to one’s name*—The child turns his/her head and looks at the caregiver’s face when being called

13. Affective positive expression—The infant demonstrates at least one of the following behaviours laughs, approaches, seeks comfort, shows enthusiasm, tries to be hugged or touched

14. Affective negative expression—The infant demonstrates at least one of the following behaviours—cries, screams, whimpers, runs away, avoids contact, refuses to be cuddled or touched

15. Functional play*—The infant plays with a toy in the way it is intended, engages in appropriate play with an object or toy

16. Pretend play*—The infant uses an object or toy in a non-intended way, as if it were a different object or toy

17. Conventional Social games—The infant engages in conventional social games with the caregiver or another person. This is shown by participation, smiling, enthusiasm, etc.

1. * Denotes items that were taken from the FOSPAC and reoperationalised for the current study

Appendix B

Qualitative Codings of Social Behaviours

1. Eye Contact

0 = infant shows age—and contextually—appropriate level of eye-contact with other persons or the camera held by a person, duration of eye-contact seeming appropriate

1 = infant shows a slight deficiency in eye-contact with other persons or the camera held by a person, but still engages in some eye-contact; that is, eye-contact occurs but may be fleeting and of short duration, or may sometimes consist of empty, lifeless or vacant stares

2 = infant shows a moderate deficiency in eye-contact with other persons or the camera held by a person, rarely engaging in eye-contact and with extremely short duration, or may often consist of empty, lifeless or vacant stares

3 = infant never engages in eye-contact or continuously stares vacantly and lifelessly

2. Affective expression (+)

0 = infant demonstrates a full and appropriate range of these behaviours, contextually appropriate

1 = infant shows a range of affect such as smiling but at times it might appear limited or inappropriate

2 = infant shows a limited range of affect, and if they do show affect it appears mainly inappropriate for the context

3 = infant shows no affect

3. Affective expression (−)

0 = child demonstrates minimal negative affect (e.g., tantrums, restlessness)

1 = infant shows negative behaviour but mostly they are contextually appropriate and easily abated

2 = infant shows frequent displays of tantrums, difficult to abate

3 = infant consistently engages in tantrums and negative behaviours, being extremely difficult to abate

4. Gaze aversion

0 = infant’s “looking behaviour” appears to be appropriate for their age and situation

1 = infant at times may appear aloof and actively avoid eye-contact or stare blankly into space

2 = infant appears to avoid eye-contact often and stare blankly into space

3 = infant consistently demonstrates gaze avoidance

5. Nestling

0 = infant shows age—appropriate level and intensity of nestling with other

1 = infant shows a slight deficiency in nestling behaviour—when nestling occurs it may be fleeting or with less bodily contact

2 = infant shows a deficiency in nestling behaviour with other, rarely engaging in nestling and with extremely short duration and low bodily contact

3 = infant never engages in nestling and actively resists such approaches

N/O = no opportunity to demonstrate nestling

6. Social peer interest

0 = infant shows appropriate level of interest in other children and siblings

1 = infant showed some signs of interest in other children but at times was aloof (seems unaware) or frightened

2 = infant showed very little interest in other children, often seeming aloof or unaware of what the other child is doing

3 = infant shows no signs of interest in peers almost never responding or initiating interaction with them,, seems consistently aloof or unaware

N/O = no opportunity

7. Conventional games

0 = infant shows age—and contextually—appropriate level of conventional play with other persons, demonstrating many of these behaviours

1 = infant shows a slight deficiency in play, engaging in only some of these behaviours

2 = infant shows a moderate deficiency in play, rarely engaging in any of these behaviours

3 = infant shows an extreme deficiency in play, infant never engages in conventional play, never demonstrating these behaviours

N/O = no opportunity