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ASD Video Glossary

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The upgrade to our ASD Video Glossary site has been completed. If you have already registered to use the ASD Video Glossary, you will need to re-register to gain access again. We apologize for any inconvenience. 


If you are a professional who is interested in showing these video clips in an upcoming presentation or training session, you may do so by linking your computer directly to theASD Video Glossary on the Internet when you train or present. Alternatively, you can order a copy of the DVD, On the Spectrum: Children and Autism, a 24-minute educational video that shows side-by-side clips of typical and atypical development. Some of these clips are used in the ASD Video Glossary. For ordering information,click here.

Introduction 
Welcome to the ASD Video Glossary, an innovative web-based tool designed to help parents and professionals learn more about the early red flags and diagnostic features of autism spectrum disorders (ASD). 

This glossary contains over two hundred video clips and is available to you free of charge. Whether you are a parent, family member, friend, physician, clinician, childcare provider, or educator, it can help you see the subtle differences between typical and delayed development in young children and spot the early red flags for ASD. All of the children featured in the ASD Video Glossary as having red flags for ASD are, in fact, diagnosed with ASD.

Please keep in mind that there are many presenting features associated with ASD that are depicted in the video clips you are about to see. However, most children do not show all of the features all of the time. Instead, many children have some of the features some of the time. Awareness of these common presenting features may help to heighten your index of suspicion. Individually, they may not indicate a problem; however, in combination, they may indicate a need to conduct a screening or a diagnostic evaluation. Not all signs and features need be present for ASD to be diagnosed. Please note: the ASD Video Glossary is not a diagnostic tool. 

System Check 
Click here to see the System Check information. Make sure your computer is configured to run the ASD Video Glossary. FAQs may also provide answers to your technical questions about using the ASD Video Glossary.

How to Use 
The ASD Video Glossary is easy to use and very intuitive. 

Important: If you have a pop-up blocker enabled on your system please turn it off before proceeding. Click on the "FAQ's" tab above for instructions to turn off your pop-up blocker. 

To launch the ASD Video Glossary, click the button below or use the "Login" tab at the top of this page. If you have previously registered to use the ASD Video Glossary, you will need to re-register to access it again. We apologize for this inconvenience.

 

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Roll over the navigational buttons and a brief overview of the topic area appears at the top right. 

Click on the navigational button to enter the topic area. Additional content areas appear under each topic and clicking on them presents more video clips to view. Click the “Play” button for the video clip you'd like to view once it has completed loading. Many of the content areas have more than one pair of video clips to view. Click on the number in the center gold box between the video players to select another pair of video clips to view.

Also, you may browse specific glossary terms by clicking on the "Glossary of Terms" tab at the top of this page. For many of the terms described, there is a link directly to the video clips in the ASD Video Glossary that best illustrate the terms. 

User Agreement 
Content within the ASD Video Glossary is copyrighted by Florida State University and First Signs, Inc. By registering to use the ASD Video Glossaryyou agree not to download, post, copy, distribute, or create derivative works based on this material, without the permission of Florida State University and/or First Signs, Inc. Even if you have software that prompts you to "download this video", you do not have permission to do so. Further, we ask you to respect the privacy of the children and families who are portrayed in the video clips. 

Credits 
The ASD Video Glossary was created by Amy M. Wetherby, PhD, Director of Florida State University FIRST WORDS® Project and Nancy D. Wiseman, Founder and President of First Signs®. Technical support was provided by Steve Barnes, Florida State University. Site architecture and design by Gold n Fish Marketing Group; programming by Abacast, Inc.. Funding was provided by Autism Speaks, The Joseph LeRoy & Ann C. Warner Fund, John Leopold Weil and Geraldine Rickard Weil Memorial Charitable Foundation, Inc., and Abacast, Inc. 

Special Acknowledgments 
Our deepest gratitude goes to the families and clinicians who participated in this video project. It is because of your generosity that so many other families and professionals throughout the world will be able to learn from your children. And a heartfelt "Thank You" to the panel of professionals and parents who reviewed the ASD Video Glossary, including Peter Bell, Lisa Goring, Rebecca Landa, PhD, Catherine Lord, PhD, Audrey Mars, MD, Tracy McDonald, Jennifer Pinto-Martin, PhD, Catherine Rice, PhD, Wendy Stone, PhD, and Audrey Thurm, PhD. 

First Signs® is a national non-profit organization dedicated to educating parents and professionals about the early signs of autism and related disorders through public awareness and training. Funding for On the Spectrum: Children and Autism, from which video clips were selected for use in the ASD Video Glossary, was provided by Cure Autism Now (CAN), New Jersey Governor's Council on Autism at UMDNJ, and Parents of Autistic Children (POAC).

Florida State University Autism Institute in the College of Medicine at FSU was established to promote interdisciplinary research to advance scientific knowledge of ASD, bridge the research-to-practice gap, and maximize the use of innovative technology to build the capacity of communities and families to improve outcomes of individuals with ASD. Dr. Amy M. Wetherby serves as Director and is a Distinguished Research Professor in the Department of Clinical Sciences at FSU. Two research projects in the FSU Autism Institute have contributed to the content and development of the ASD Video Glossary. The FIRST WORDS® Project is a prospective, longitudinal research investigation designed to identify early red flags of autism from video of children screened under 24 months of age who are later diagnosed with autism spectrum disorder. As Principal Investigator, Dr. Wetherby has received funding from the US Department of Education, National Institutes of Health, and Centers for Disease Control and Prevention. The research findings will have important implications for improving early screening and identification. The Early Social Interaction Project (ESI) is a multisite toddler treatment study in the FSU Autism Institute funded by the US Department of Education, Autism Speaks, and the National Institute of Mental Health. Dr. Amy Wetherby and Dr. Catherine Lord, Director of the Institute of Brain Development in New York, are Co-Principal Investigators of an ongoing randomized clinical trial of the effectiveness of teaching parents of 100 toddlers with ASD how to support social communication, emotional regulation, and play in everyday activities beginning at 18 months of age using the ESI model. The findings of this study will provide important evidence of the effectiveness of a community-based intervention implemented by parents of toddlers with ASD and will substantiate the importance of autism screening for toddlers so families can access early intervention.

Autism Speaks is the nation's largest autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments, and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. Autism Speaks was founded in February 2005 by Suzanne and Bob Wright, the grandparents of a child with autism. Bob Wright is Senior Advisor at Lee Equity Partners and served as vice chairman, General Electric, and chief executive officer of NBC and NBC Universal for more than twenty years. He also serves on the board of directors of the Polo Ralph Lauren Corporation and RAND Corporation. Suzanne Wright has an extensive history of active involvement in community and philanthropic endeavors, mostly directed toward helping children. She serves on the boards of several non-profit organizations and is also Trustee Emeritus of Sarah Lawrence College, her alma mater.

ASD Video Glossary || Copyright © 2009 by Autism Speaks Inc., Florida State University, and First Signs, Inc. All rights reserved. FIRST WORDS Project & Design are trademarks owned by Florida State University. First Signs & Design are trademarks owned by First Signs, Inc. ASD Video Glossary text copyright © by Florida State University and First Signs, Inc. All rights reserved. Copyright in the ASD Video Glossary video clips contained herein is the property of Florida State University or First Signs, Inc., as designated thereon.

Early Red Flags of Autism Spectrum Disorders

There is now mounting evidence demonstrating the effectiveness of intensive early intervention with a substantial proportion of young children with autism spectrum disorders (ASD).

Research indicates that intervention provided before age 3½ has a much greater impact than if it begins after age 5, which underscores the importance of improving early identification. In spite of the severity of the behavioral characteristics of most children with ASD, the median age for diagnosis of ASD in the United States is 4½ years1. Although there have been significant advances in genetic and biomedical research on ASD, there is currently no biological marker for either autism or ASD, therefore screening and diagnosis must be based on behavioral features.

The American Academy of Pediatrics (AAP) recently published a policy statement for the identification and evaluation of children with ASD that recommended that all children be screened with a standardized broadband screening tool at the 9-, 18-, 24- and 30-month visits, and an ASD-specific screening tool at the 18- and 24-month visits2. The new AAP practice guidelines make the need for validated screening tools more pressing. The ongoing research of the FIRST WORDS Project is contributing important findings on screening tools for early identification of children with ASD at the ages recommended by the AAP. Following is a brief summary of our research findings.

FIRST WORDS® Project
Prospective Longitudinal Research Study of ASD

We are conducting an ongoing prospective, longitudinal study to identify precise early indicators of ASD by examining videotaped communication samples collected during the second year of life. Participants were recruited from a pool of 5,385 children screened by having parents complete the Infant-Toddler Checklist (ITC) when their children were under two years of age. Children were later assigned to groups based on the results of a follow-up diagnostic evaluation at 3 to 5 years of age, which included the Autism Diagnostic Observation Schedule, the Social Communication Questionnaire, the Vineland Adaptive Behavior Scales, and the Mullen Scales of Early Learning. The ASD and DD groups did not differ on their nonverbal or verbal developmental quotient. To date, we have identified 60 children later diagnosed with ASD and comparison groups of 30 children with developmental delays in which ASD is ruled out (DD), and 60 children with typical development (TD)3-7.

Accuracy of the ITC as a
Broadband Screener of Communication Delay

The ITC is one component of the Communication and Symbolic Behavior Scale Devlopmental Profile (CSBS DP) and consists of 24 questions about typical social communication milestones and a question about parent concern. To examine the accuracy of the ITC for early identification of communication delays, the agreement between children’s screening outcomes on the ITC was compared with their developmental outcomes on the CSBS DP Behavior Sample5. Following are the results for the ITC screen and parent report of concern:

  Age in Months at ITC Screen
Accuracy of ITC Screen 9-11 12-14 15-17 18-20 21-24
Sample Size 259 330 238 219 128
ITC Screen Result          
Sensitivity (True Positives) 82% 98% 92% 82% 86%
Specificity (True Negatives) 89% 84% 78% 86% 82%
Parent Report of Concern          
Sensitivity (True Positives) 30% 24% 34% 49% 60%
Specificity (True Negatives) 84% 82% 83% 68% 39%

The findings of this study suggest that parents of children 9-24 months are fairly accurate at reporting current developmental milestones but are not very accurate in reporting concern about their child’s development relative to what should be expected at their child’s age. This finding is important to consider because parent concern can influence whether parents seek out or agree to participate in screening and evaluation. The majority of parents of children under 21 months with delayed communication do not report concern. In contrast, a substantial percentage of parents of children 21-24 months report concern whether their child is typical or delayed.

Accuracy of the ITC to Detect Children with ASD

The ITC identified 56 of the 60 children with ASD in this general population sample which is 93% sensitivity5. However, it is important to point out that a positive screen on the ITC does not distinguish children with ASD from children with other communication delays. Children with ASD who had a positive screen on the ITC were most likely to perform in the bottom 10th percentile on the Social composite. Therefore, an ASD-specific screen should be considered particularly for children showing this pattern on the ITC. For the children with ASD screened one or more times with the ITC, the percentage of positive screens and parents with concern reported on the ITC are presented below.

  Age in Months at ITC Screen
Children with ASD 9-11 12-14 15-17 18-20 21-24
Sample Size 13 11 17 13 19
Positive Screen on ITC 77% 91% 100% 92% 95%
Parents Reporting Concern 31% 45% 53% 69% 74%

The percentage of positive screens on the ITC increased with age and is above 90% at 12-14 months through 21-24 months. The proportion of parents with concern is less than half under 15 months and increases to more than two-thirds at 18-20 months and approaches three-fourths at 21-24 months. The results of this study support the validity of the ITC as a broadband screener of communication delays including ASD in children 9-24 months of age.


Red Flags of ASD from Structured Observations in the Second Year of Life

To identify early red flags of ASD, the videotaped communication samples from the second year of life were analyzed to examine differences between the children later diagnosed with ASD and the comparison groups3-7. The videotapes were analyzed for typical social communication milestones and atypical behaviors that may be associated with ASD. The results indicated that 9 red flags distinguished the children with ASD from the children with DD and TD and 4 red flags distinguished children with ASD and DD from children with TD:

red flags

These findings are on one of the largest samples of children with ASD identified prospectively at this young age and contribute to understanding the early phenotypic features of ASD. They offer more precise early red flags of ASD in the second year of life than previously available.

Conclusions

The combination of 1st stage screening for developmental delay with the ITC and 2nd stage screening for ASD with the 13 Red Flags identified from the CSBS DP Behavior Sample was effective for early identification. Children with ASD can be distinguished from those with DD and TD through systematic observation in the second year of life. The 13 red flags identified in our research include a combination of lack of typical behaviors and presence of atypical behaviors. These findings have important implications for improving early identification so that families can access intervention sooner.

References

  1. Centers for Disease Control and Prevention (2007). Prevalence of autism spectrum disorders- Autism and developmental disabilities monitoring network, Six sites, Unites States, 2000-2002. In Surveillance Summaries, February 9, MMWR 2007; 56 (No. SS-1): 1-40.
  2. Johnson, C.P. & Scott, M.M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183-1215.
  3. Morgan, L., Wetherby, A., & Barber, A. (accepted for publication). Repetitive and stereotyped movements in children with autism spectrum disorders late in the second year of life. Journal of Child Psychology and Psychiatry.
  4. Watt, N., Wetherby, A., Barber, A., & Morgan, L. (accepted for publication) Repetitive and stereotyped behaviors in children with autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders.
  5. Wetherby, A., Brosnan-Maddox, S., Peace, V., & Newton, L. (invited article under review). Validation of the Infant-Toddler Checklist as a broadband screener for autism spectrum disorders from 9 to 24 months of age.
  6. Wetherby, A., Watt, N., Morgan, L., & Shumway, S. (2007). Social communication profiles of children with autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders, 37, 960-975.
  7. Wetherby, A., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. (2004). Early indicators of autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders, 34, 473-493.

Autism Links

American Academy of Pediatrics (AAP)

General information related to child health, specific guidelines concerning pediatric issues, information about AAP's programs and activities, publications and other child health resources. Information comes from child health experts with scientific research supporting their recommendations.

Autism Speaks

Autism Speaks is dedicated to increasing awareness of autism spectrum disorders, to funding research into the causes, prevention, treatments and cure for autism, and to advocating for the needs of affected families.

Autism Society of America (ASA)

ASA’s mission is to improve the lives of all affected by autism. They do this by increasing public awareness about the day-to-day issues faced by people on the spectrum, advocating for appropriate services for individuals across the lifespan, and providing the latest information regarding treatment, education, research and advocacy.

Autism Spectrum Disorder (ASD) Video Glossary

The ASD video glossaryis an innovative web-based tool designed to help parents and professionals learn more about the early red flags and diagnostic features of autism spectrum disorders.   The ASD video glossary was completed in collaboration with the FIRST WORDS® Project, First Signs and Autism Speaks.

Centers for Disease Control and Prevention 

Easy to read information on facts, screening, diagnosis and treatments.

First Signs

First Signs is dedicated to educating parents and professionals about the early warning signs of autism and related disorders. The First Signs website provides a wealth of vital resources, covering a range of issues: from monitoring development, to concerns about a child; from the screening and referral process, to sharing concerns.

National Institute of Mental Health

NIMH envisions a world in which mental illnesses are prevented and cured.
The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure.