The Development of Referential Communication and Autism Symptomatology in High-Risk Infants


Correspondence should be sent to Lisa V. Ibañez, University of Washington, Autism Center, CHDD, P.O. Box 357920, Seattle, WA 98195. E-mail:


Non-verbal referential communication is impaired in children with autism spectrum disorders (ASD). However, the development of difficulties with referential communication in the younger siblings of children with ASD (High-Risk Siblings)—and the degree to which early referential communication predicts later autism symptomatology—is not clear. We modeled the early developmental trajectories of three types of referential communication: responding to joint attention (RJA), initiating joint attention (IJA), and initiating behavioral requests (IBR) across 8, 10, 12, 15, and 18 months of age in High-Risk Siblings (= 40) and the infant siblings of children without ASD (Low-Risk Siblings; = 21). Hierarchical linear modeling indicated that High-Risk Siblings exhibited lower levels of baseline RJA and IJA and a lower rate of linear change in IBR than Low-Risk Siblings. When the 10 High-Risk Siblings who received an ASD diagnosis were excluded from analyses, group differences in the development of referential communication remained significant only for RJA. Baseline levels of IJA were associated with later ASD symptomatology among High-Risk Siblings, suggesting that individual differences in referential communication development at 8 months may index early manifestations of ASD.