Exploring individual trajectories of social communicative development in toddlers at risk for autism spectrum disorders

Whilst impairments in joint attention, imitation, and pretend play are well documented in children with autism spectrum disorder (ASD), the developmental trajectories of these symptoms remain unknown. The main objective was to explore these trajectories in a sample of children at risk for ASD between the ages of 2 and 4 years. After screening positive for ASD, 17 children were prospectively followed with 6-monthly assessments of social communicative skills and general development. During this study, 9 children were diagnosed with ASD. Results showed that there was growth in imitation skills and in pretend play ability. Also, a slightly increased amount of initiation of joint attention was noted. However, the quality of joint attention behaviours did not significantly improve and growth rates did not significantly differ between children with ASD and non-ASD cases. There was a great intra-individual variability, especially in the performances on the imitation tasks. Also interindividual variability was apparent: some children with ASD showed a delayed development of imitation or pretend play, whereas others had a more clearly deviant developmental profile. The importance of looking at individual trajectories and variability in the study of social communicative development in children with ASD is discussed.

► Growth in social communicative skills is present in young children at risk for ASD.
► Social communicative impairments are neither universal nor specific to ASD.
► There is great intra- and interindividual variability in social communicative skills.