Parent-infant interaction in infants with Neurofibromatosis Type 1.

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Author listing: Wan, M.W., Garg, S., Kolesnik, A., Jones, E., Green, J., Johnson, M. & The British Autism of Infant Siblings (BASIS) Team. 
Background: Neurofibromatosis Type 1 (NF1) is a relatively rare single gene neurodevelopmental disorder that has a high prevalence of ASD in the pediatric population (25% with full ASD; 20% with partial symptoms). Unlike ASD, visible signs of NF1 are usually detected shortly after birth and 50% of cases are inherited. A recent case series represents the first developmental profiles of infants with NF1 and found delayed or impaired motor and communicative skills than those of at-risk infants who were subsequently diagnosed with ASD (as well as those who were not, and typically developing infants). By contrast, temperament and social engagement among infants with NF1 were relatively typical. Since infants who are later diagnosed with ASD show parent-infant interactions that diverge from those seen in typical development from around 9-10 months of age, infants with NF1 may show further divergence in such interactions, with implications for their social and communicative development.

Objectives: As part of the prospective Early Development in Neurofibromatosis Type 1 (EDEN) project, we examined the parent-infant interactions of 12 infants with NF1 at 10-11 months. The aims are: (1) to describe their parent-infant interactions, (2) to compare their interactions to those of at-risk infants who later developed ASD (from the British Autism Study of Infant Siblings; BASIS) and those who did not, and low-risk infants; (3) to explore the associations between the parent-infant interactions of infants with NF1 and concurrent motor, communicative, social and cognitive functioning.

Measures: The validated Manchester Assessment of Caregiver-Infant Interaction (MACI) is a global measure used to evaluate seven areas of interaction. Evaluations of 6-min videotaped unstructured play interaction were made by two independent trained coders blind to all family information. The Mullen Scales of Early Development and Vineland Adaptive Behavior Scale (Parent Form) were completed as part of a battery of assessments.

Results: The parent-infant interactional styles of these infants will be described, highlighting how high object (toy) interest and low attentiveness to parent seem to have differential impacts on parental response that affect the infant’s social experience. Aspects of parent-infant interaction were correlated with their concurrent motor and communicative scores, but not their social and cognitive scores. We will report on group differences in MACI (parent-infant interaction) ratings.

Conclusions: These findings, based on N = 12, are consistent with the interpretation that the early emergence of motor and communicative difficulties in infants with NF1 may impact on their social interactions with their parents in specific ways that may reduce the social opportunities open to them that are important for communicative and social development. Furthermore, unlike infants at familial risk of ASD, which require them to have an older sibling with ASD, these infants do not necessarily have a sibling. Thus, these early findings may be taken as support for altered parent-infant interaction being the result of the emergence of early neurodevelopmental markers rather than learned interactive styles (from interacting with the older child in the case of ASD).

Period13 May 2018
Held atInternational Society for Autism Research, Netherlands
Degree of RecognitionInternational