Early Predictors in Infancy for a Developing Neurobehavioral Disorder – a Pilot Study

Background: The increasing incidence of Neurobehavioral Disorders (NBDs), such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Coordination Disorder (DCD), is of major concern in public health. Although early detection of a developing NBD is critical to enable intervention while brain plasticity is prominent, no screening tool for NBD development at infancy is available.

Objective:The aim here was to assess whether risk factors that predict forthcoming NBDs can be identified at early infancy.

Methods: The Israeli Health system provides a general developmental screening system from birth through preschool years at special clinics. In a retrospective cohort study the charts of 161 toddlers, who were diagnosed at a later age for NBDs [47 Autism Spectrum Disorder (ASD), 56 Developmental Coordination Disorder (DCD), 58 Attention Deficit Hyperactivity Disorder (ADHD)], were evaluated and compared to the records of 58 children with typical development. Ten covariates including 28 parameters were accumulated, compared and statistically analyzed.

Results: Deviation from trajectories of seven parameters (gestational age, birth weight, head circumference percentile, weight percentile, gross motor development, difficulties in communication and language) seem collectively to predict ASD with 85% probability. The first five parameters may collectively predict DCD with 72% probability. Predictors of ADHD with 58% probability have been described (Gurevitz et al 2014).

Conclusions:This cohort retrospective study illuminates risk factors at infancy that may predict the development of NBDs. Most prominent are deviations from weight followed by deviations in head circumference trajectories, and delay in motor development due to muscle strength and tone irregularities. Identification of risk factors at infancy is crucial for early intervention programs, such as prevention of rapid changes in weight and manipulations to strengthen motor development and the corresponding neural circuits. The sooner risk factors are recognized, more efficient an early tailored bio-psycho-social treatment might be.