We evaluated repetitive behavior with objects in infants at risk for autism spectrum disorder (ASD) from 9 to 36 months of age, and associations between early repetitive behavior and social engagement. Infant siblings of children with ASD (high-risk) or typical development (low-risk) were administered a task eliciting repetitive object use at 9, 12, 15, 18, 24, and 36 months of age. Infants (n = 147) were classified into 1 of 3 outcome groups at 36 months: Low-Risk Non-ASD (n = 58), High-Risk Non-ASD (n = 72), and ASD (n = 17). Behavior was coded from video for frequencies of unusual visual inspection, spinning, and rotating behaviors. Differences in unusual visual inspection were most prominent, consistent, and present earliest: At 9 months, the ASD group engaged in this behavior more frequently than both other groups, persisting through 36 months. Differences in frequencies of spinning and rotating were later-appearing, more time-limited, and/or related to familial ASD risk rather than ultimate diagnosis. Sensitivity and specificity estimates for the presence of unusual visual inspection at 9 months of age were in the moderate range (.60 and .68, respectively) for ASD versus Low-Risk Non-ASD comparisons, generally increasing over time. Unusual visual inspection at 9 months predicted 12-month social behavior controlling for 9-month social behavior, but not vice versa, with no evidence of moderation by ASD diagnosis. In summary, unusual visual inspection of objects is present and stable by 9 months of age in infants developing ASD and predicts reduced social engagement three-months later. Close monitoring of this behavior may aid early detection. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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早在 9 个月时，患有自闭症的婴儿对物体的重复行为就可以预测诊断和后来的社会行为。

我们评估了 9 至 36 个月大的患有自闭症谱系障碍 (ASD) 风险的婴儿对物体的重复行为，以及早期重复行为与社会参与之间的关联。患有 ASD（高风险）或典型发育（低风险）儿童的婴儿兄弟姐妹在 9、12、15、18、24 和 36 个月大时接受了一项引发重复使用物品的任务。婴儿 (n = 147) 在 36 个月时被分为 3 个结果组中的一个：低风险非 ASD (n = 58)、高风险非 ASD (n = 72) 和 ASD (n = 17)。行为是根据视频编码的异常视觉检查、旋转和旋转行为的频率。不寻常的视觉检查的差异最为突出、一致且最早出现：在 9 个月时，ASD 组比其他两组更频繁地参与这种行为，坚持36个月。旋转和旋转频率的差异出现较晚，时间有限，和/或与家族性 ASD 风险相关，而不是最终诊断。对于 ASD 与低风险非 ASD 比较，9 个月大时存在异常目视检查的敏感性和特异性估计值处于中等范围（分别为 0.60 和 0.68），通常随着时间的推移而增加。9 个月时不寻常的目视检查预测 12 个月的社会行为控制 9 个月的社会行为，但反之亦然，没有证据表明 ASD 诊断有缓和作用。总而言之，在患 ASD 的婴儿 9 个月大时，对物体的不寻常的视觉检查是存在的并且稳定，并且预测三个月后社会参与度会降低。密切监视此行为可能有助于及早发现。