Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


48th Annual Convention; Boston, MA; 2022

Event Details

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Symposium #332
CE Offered: BACB
Early Identification and Treatment of Autism Symptomatology in Infant Siblings
Sunday, May 29, 2022
5:00 PM–5:50 PM
Meeting Level 2; Room 254A
Area: AUT/DDA; Domain: Applied Research
Chair: Rebecca P. F. MacDonald (New England Center for Children)
CE Instructor: Rebecca P. F. MacDonald, Ph.D.

While there is a growing body of research examining early symptoms of ASD, the point at which this pattern of atypical social responding begins to deviate in children who are later diagnosed with autism is unclear. The first paper in this session describes data obtained using a newly developed research tool, the Early Markers of Autism, on infants under 6 months of age. Assessment data using the EMA reveal the presence of five key early markers in infant siblings and the accurate assessment of each using this tool. The second paper in this session describes the assessment and treatment of stereotypy in a 10-month-old infant who was at risk of ASD. Using a multiple baseline design, two topographies of stereotypy were measured and then treated using a toy manipulation procedure. The third paper in this session describes a case study of an infant who was identified to be at risk for autism at 8 weeks old and the treatment that was provide across 2 years, resulting in a loss of symptoms by 24 months. Findings from these studies have implications for the early identification and treatment of autism in infants, leading to long term positive outcomes for infants and families.

Instruction Level: Intermediate
Keyword(s): autism, assessment
Target Audience:


Learning Objectives: 1. The participant will be able to describe the research on early identification of symptomatology in infant siblings. 2. The participant will be able to describe the early social deficits in children with autism. 3. The participant will be able to describe treatment for stereotypy in infants
Early Markers of Autism in Infant Siblings
KATHRYN COUGER (William James College), Rebecca P. F. MacDonald (New England Center for Children)
Abstract: While a preponderance of evidence indicates that autism symptomatology emerges at 6 to 12 months of age (Zwaigenbaum et. al, 2005), a recent study by Graupner and Sallows (2017) suggests that symptoms of autism can emerge in infants as early as 3 months of age. The purpose of our current investigation is to document the early emergence of autism symptomatology in high-risk infant siblings, younger than 6 months of age. The second purpose is to pilot the Early Markers of Autism (EMA) assessment tool for young infants, developed by the authors. Currently 50 high-risk siblings and 30 low-risk babies under 6 months of age are participating in this study They receive bi-weekly developmental screenings in addition to the EMA. IOA on the EMA for the high-risk participants (33.5% of sessions) is 95% agreement and for the low risk group (44.5% of sessions) IOA is 96% agreement. Data to date reveal that there are five key early markers of autism in infants, and each can be effectively assessed using the EMA. Data will be presented on the presence of these markers and the specific behavioral profile configuration of these infants. These findings have implications for the early identification of autism in infants, leading to long term positive outcomes for infants and families.

Assessment and Treatment of Stereotypy in Infants at Risk of Autism Spectrum Disorders

MORGAN SCULLY (The New England Center for Children ), Rebecca P. F. MacDonald (New England Center for Children)

Stereotypy can be one of the most persistent and difficult to treat topographies of challenging behavior exhibited by children with autism spectrum disorder (ASD). Although stereotypy is often not physically dangerous, decreasing stereotypy is a common target for clinicians and researchers for a variety of reasons. Stereotypy can interfere with skill acquisition and long-term treatment outcomes, decrease the likelihood of positive social interactions, and is often viewed as socially stigmatizing. The purpose of this study was to identify and treat motor stereotypy in an infant at risk of ASD. Although several studies have investigated the prevalence and topographies of stereotypy in young children, none have identified the age at which it emerges and demonstrated the efficacy of an intervention strategy with individuals under one year of age. Non-physical redirection of stereotypy to toy play and reinforcement for toy engagement was implemented in a multiple baseline design across topographies of stereotypy. Results indicate decreases in all topographies of stereotypy to near-zero levels across the course of the study. These findings are discussed as they relate to the implications of identifying stereotypy in infancy and developing the treatment strategies needed to intervene as soon as it is identified.

Treatment Outcomes for a Sibling Identified as Symptomatic for Autism at Eight Weeks Old
VICTORIA WEISSER (New England Center for Children), Rebecca P. F. MacDonald (New England Center for Children)
Abstract: Infant siblings of children diagnosed with Autism Spectrum Disorder (ASD) have an 18% recurrence risk at 3 years old (Osnoff et al., 2011). Graupner and Sallows (2017) reported symptoms in children under 3 months of age. The purpose of the current investigation was to document early emergence of symptomatology in a sibling and the outcomes of early treatment. Early markers were first noted at eight weeks and included: flat affect, no response to sound out of sight, no response to name/voice, eye contact avoidance, and inconsistent tracking of visual stimuli. At three months, parent-implemented treatment was initiated with little change in symptoms. At six months, 15 hours of Applied Behavior Analysis (ABA) began with greater gains in skills. However, the participant continued to perform below age level by 12 months of age. At 12 months, 30 hours of ABA began and at 22 months, the participant no longer met the requirements for an ASD diagnosis. The participant has continued to not meet requirements for an ASD diagnosis at 38 months. Interobserver agreement was assessed with an average of 82.9% across sessions. The attached graph shows the participant’s age equivalent scores on the Mullen Scales of Early Learning Assessment over time.



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