title: Infant's engagement and emotion as predictors of autism or intellectual disability in West syndrome.
abstract: West syndrome (WS) is a rare epileptic encephalopathy with early onset and a high risk of autistic outcome. The PréAut grid assesses this risk following WS onset by taking into account synchrony and emotion in interactions and by evaluating the baby's active desire to engage in pleasant interactions (especially the infant's early active behaviors that encourage being gazed at or kissed by the mother or to share joy with her). We followed a sample of 25 WS patients prospectively from disease onset and assessed whether the PréAut grid before 9 months, and the checklist for autism in toddlers (CHAT) at 18 and 24 months predicted autism or intellectual disability (ID) outcomes at 4 years. We found that the PréAut grid at 9 months (sensitivity = 0.83; specificity = 1) had similar prediction parameters as the CHAT at 18 months (sensitivity = 0.90; specificity = 0.83) and 24 months (sensitivity = 0.92; specificity = 1). WS patients with a positive PréAut screening at 9 months had a risk of having autism or ID at 4 years, which is 38 times that of children with a negative PréAut grid [OR = 38.6 (95 % CI 2.2-2961); p = 0.006]. We conclude that the PréAut grid could be a useful tool for the early detection of autism or ID risk in the context of WS. Further research is needed to assess the PréAut grid in other contexts (e.g. infants at high-risk for non-syndromic autism).
authors.affiliation: Service de Psychiatrie de l'Enfant, AP-HP, Hôpital Necker, 149 rue de Sèvres, 75015, Paris, France, lisa.ouss@nck.aphp.fr.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ouss
authors.forename: Catherine
authors.initials: C
authors.lastname: Saint-Georges
authors.forename: Laurence
authors.initials: L
authors.lastname: Robel
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bodeau
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Laznik
authors.forename: Graciela C
authors.initials: GC
authors.lastname: Crespin
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chetouani
authors.forename: Claude
authors.initials: C
authors.lastname: Bursztejn
authors.forename: Bernard
authors.initials: B
authors.lastname: Golse
authors.forename: Rima
authors.initials: R
authors.lastname: Nabbout
authors.forename: Isabelle
authors.initials: I
authors.lastname: Desguerre
authors.forename: David
authors.initials: D
authors.lastname: Cohen
mesh_terms: D017668:Age of Onset; D001321:Autistic Disorder / Q000175:diagnosis*; D002675:Child, Preschool; D042241:Early Diagnosis; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D008607:Intellectual Disability; D016015:Logistic Models; D008297:Male; D009035:Mothers; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013036:Spasms, Infantile / Q000175:diagnosis*