Researchers have found a striking commonality that unites most infants who will go on to be diagnosed with ASD. Results of both retrospective video reviews & prospective, high-risk infant studies clearly indicate that many future ASD infants are able to establish a normal relationship with parents during the early months of the infant’s life. However, it appears that sometime towards the latter part of their first year, most infants later diagnosed with ASD begin a process of relationship disengagement that parents, no matter their efforts, are unable to reverse.
Emotional Engagement During the Early Months
To demonstrate the phenomena of early relationship disengagement, it is important to demonstrate not only that ASD infants demonstrate signs of disengagement by the end of their first year, but that they do not appear different from typically developing peers during the first months of life.
In an early prospective study, Bryson and colleagues, described a consistent pattern of apparently typical social responsiveness, shared enjoyment and appropriate eye gaze at 6months, followed by reduced social engagement, shared enjoyment and non-verbal communication by age 12 months (Bryson et al. 2007).
Young and colleagues found that patterns of infant gaze and affect towards mothers at 6 months were not related to measures of symptom severity at 24 months. ASD infants were found to engage in typical patterns of gaze to their mother’s face, including decreased attention to mother during the non-responsive phase of the ‘Still Face’ paradigm (Young et al., 2009)
Rozga and colleagues found that at 6 months, ASD infants demonstrated typical patterns of gaze and affect during a ‘Still Face’ paradigm. with a decrease in gaze to mother and a decrease in smiling during the non-responsive phase. Infants later diagnosed with ASD also showed typical rates of social smiling, social vocalizations and direction of looks, smiles and vocalizations toward mother during a less structured face-to-face interaction. Contrary to predictions here was actually a trend for infants later diagnosed with ASD to show greater amounts of gaze to mother’s face throughout the task. The authors conclude that these studies suggest that ASD infants demonstrate relatively typical engagement in social interaction with their mother at 6 months (Rozga et al. 2011).
Wan and colleagues reported that Infants diagnosed with ASD at 36 months show reduced attentiveness to their mother during naturalistic interaction at 12 but not 6 months (Wan et al., 2012).
Clifford and colleagues found that infants diagnosed with ASD at 36 months were rated by their parents as less cuddly and less likely to smile during caretaking and play at 14 and 24 months relative to low risk infants. However these differences were not apparent at 7 months of age (Clifford et al., 2013).
Similarly to prior studies, Jones and Klin could find no significant differences in gaze or affect towards mother in ASD infants compared to their typically developing peers. They reported that ASD infants showed typical rates of social smiling, social vocalizations and direction of looks (Jones and Klin, 2013)
Ozonoff and colleagues in two major longitudinal studies, found evidence to support a progressive pattern of declining social engagement between 6 and 24 months, including decreased social smiling and facial gazing. They observed that the greatest decline in ASD infant’s social engagement emerged by 12 months and continued to become more pronounced over time (Ozonoff et al. 2010; 2014).
Filliter and colleagues also reported the results of their longitudinal study, focusing on the display positive affect in infants siblings of children diagnosed with ASD. Their findings, that while ASD infants showed significantly less affect at 12 months, no group differences were found at 6 months, support the accumulating evidence of relationship disengagement during the latter part of the first year (Filliter et al. 2014).