UC Davis M.I.N.D. Institute researchers say simple test can initiate earlier assessment and intervention

Photo of Sally Ozonoff Sally Ozonoff's research focuses on identifying the earliest possible behavioral indicators of autism.

Year-old babies who do not respond when their name is called may be more likely to be diagnosed with an autism spectrum disorder or other developmental problem at age 2, making this simple test a potential early indicator for such conditions. The study, led by researchers at the UC Davis M.I.N.D. Institute, is published in the April issue of Archives of Pediatrics & Adolescent Medicine.

“Parents would often tell us that they suspected something was wrong with their children well before they received an official diagnosis,” said Sally Ozonoff, professor of psychiatry and behavioral sciences with the M.I.N.D. Institute and senior author of the study.

“We set out to pinpoint the earliest possible behavioral indicators of autism. Whether or not children respond to their names by 12 months of age is turning out to be a good early indicator of developmental issues.”

Autism, which is identified by repetitive behaviors and deficits in language development and social interactions, is usually diagnosed around age 3 or 4. That diagnosis usually initiates interventions that can reduce the disabilities associated with the disorder. This has motivated a growing body of research that aims to identify the earliest possible indicators of autism.

“The goal is to intervene as early as possible,” said Aparna Nadig, a post-doctoral fellow at the M.I.N.D. Institute and first author of the study. “Earlier identification leads to earlier intervention, which can improve outcomes for children with autism.”

"The response-to-name test turned out to be a very good marker of a developmental issue. Most of the children who failed to respond to their names at 12 months of age had autism, general developmental delays, behavioral problems or social communication problems."
— Sally Ozonoff, professor of psychiatry and behavioral sciences at the UC Davis M.I.N.D. Institute

Ozonoff, Nadig and colleagues compared infants whose older siblings had autism and are therefore at risk for autism with infants who were not at high risk of developing the disorder. While each child sat at a table playing with a small toy, a researcher walked behind the child and called his or her name in a clear voice. If the child did not respond after three seconds, the name was called again — up to three times in all.

Fifty-five at-risk infants and 43 control infants completed this test at age 6 months, and 101 at-risk infants and 46 control infants were tested at age 12 months.

“The response-to-name test turned out to be a very good marker of a developmental issue. Most of the children who failed to respond to their names at 12 months of age had autism, general developmental delays, behavioral problems or social communication problems,” said Ozonoff.

Forty-six at-risk infants and 25 control infants were followed up for two years; three-fourths of those who did not respond to their name at age 12 months were identified with developmental problems at age 2. Of the children who were later diagnosed with autism, half failed the test at one year, and, of those who were identified as having any type of developmental delay including autism, 39 percent failed the test.

“Since this task is easy to administer and score and takes few resources, it could be easily incorporated into well-child pediatric visits at 12 months of age,” Nadig said.

“A child who fails to orient to his or her name should be referred for more comprehensive assessments and possibly behavioral treatment.”

Photo of Dr. Sally Rogers with pediatric patient The primary goal of early autism diagnosis is early intervention, which can help reduce the disability associated with the disorder. Professor Sally Rogers of the M.I.N.D. Institute is testing early intervention techniques with toddlers.

The response-to-name research is part of a larger nationwide network of researchers — the Baby Sibling Research Consortium — who are assessing whether or not one or more specific behaviors can be reliable indicators of a later diagnosis of autism. In addition to response to name, researchers are considering behavioral patterns such as greater interest in objects than people and differences in face processing.

“Until we can more accurately define the biology of autism, behavioral science is our best resource for diagnosing and treating autism as early as possible,” said Ozonoff. The response-to-name research was funded by a grant from the National Institutes of Health. A copy of the research study and radio actualities are available at www.jamamedia.org.

The UC Davis M.I.N.D. (Medical Investigation of Neurodevelopmental Disorders) Institute is a unique, collaborative center for research into causes, preventions and treatments for autism, fragile X syndrome, Tourette syndrome, learning disabilities and other neurodevelopmental disorder. For further information, please visit www.mindinstitute.org.