Recognizing Disability and Ability in Young Autistic Children

Autism Spectrum Disorder (ASD) is characterized by impairments, or disabilities, in social communication and interaction (SCI), and restricted and repetitive behaviors (RRBs), but is also associated with enhanced abilities. Early identification of disability in ASD has been a primary focus in clinical practice, while abilities associated with ASD have neither been recognized nor assessed. The overarching purpose of this thesis was to improve early recognition of both disability and ability in young autistic children. Three studies were conducted in a largely overlapping sample of 3-year-old high-risk-for-ASD siblings, either with or without ASD, and low-risk-for-ASD siblings. Study I and II focused on the value of preschool staff as informants in early identification of autistic symptoms, while Study III investigated potential strengths in visual ability in autistic children. Study I investigated how accurately parents and preschool staff rated autistic symptoms in relation to diagnoses and clinical assessment of autistic symptoms. Results showed that ratings by preschool staff were more accurate than parent ratings at differentiating the ASD group from the two other groups, and more closely associated with clinical autistic symptoms. Study II focused on preschool staff’s ratings of social communication and interaction (SCI) and restricted and repetitive behaviors (RRBs). Results showed that ratings of SCI were more accurate than RRBs in differentiating the ASD group from the two other groups, and only the SCI ratings correlated with clinical assessment of social impairment. Study III investigated specific aspects of visual ability with five visual tasks. Similar performance on visual ability was found among groups, except for the Hidden Pictures (HP) task. The children with ASD had superior performance on HP compared with the other two groups. Results of Study I and II suggest that preschool staff report on autistic symptoms may complement parent report in diagnostic assessment of ASD, although their report on RRBs should be interpreted with caution. The results of Study III indicate that enhanced visual ability can be identified in autistic children already at age three. Overall, this thesis suggests that information from preschool staff and assessment of visual ability can contribute to the early recognition of disability and ability in young children with ASD