Alyssa Orinstein - Academia.edu (original) (raw)

Papers by Alyssa Orinstein

Research paper thumbnail of Language and Verbal Memory in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

Journal of Autism and Developmental Disorders, 2014

Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle... more Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the average range or above on all measures and showed few differences from the TD group. The HFA group performed within the average range but showed significantly lower mean performance than the other groups on multiple language measures, even when controlling for verbal IQ. Results also indicate that OO individuals show strong language abilities in all areas tested, but that their language may show greater reliance on verbal memory.

Research paper thumbnail of Ratings of Broader Autism Phenotype and Personality Traits in Optimal Outcomes from Autism Spectrum Disorder

Journal of Autism and Developmental Disorders, 2016

The study examines whether "optimal outcome" (OO) children, despite no longer m... more The study examines whether "optimal outcome" (OO) children, despite no longer meeting diagnostic criteria for Autism Spectrum Disorder (ASD), exhibit personality traits often found in those with ASD. Nine zero acquaintance raters evaluated Broader Autism Phenotype (BAP) and Big Five personality traits of 22 OO individuals, 27 high functioning individuals with ASD (HFA), and 23 typically developing (TD) peers. HFA children displayed higher ratings than their peers on all BAP traits. OO were indistinguishable from TD, with the exception of greater extraversion (e.g., increased talkativeness), a potential tendency to be less emotionally stable, and pragmatic language deficits such as getting sidetracked in conversation. Overall, OO individuals are not showing BAP characteristics, but may be subject to other mild ADHD-like characteristics.

Research paper thumbnail of Residual Communication and Social Deficits in Individuals with a History of Autism Spectrum Disorders Who Achieved Optimal Outcomes

Research paper thumbnail of Language comprehension and brain function in individuals with an optimal outcome from autism

NeuroImage: Clinical, 2016

Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individ... more Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO). The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as most participants with OO received years of intensive therapy that could alter brain networks to align with typical function or work around ASD-related neural dysfunction. Individuals ages 8 to 21 years with high-functioning ASD (n = 23), OO (n = 16), or typical development (TD; n = 20) completed a functional MRI scan while performing a sentence comprehension task. Results indicated similar activations in frontal and temporal regions (left middle frontal, left supramarginal, and right superior temporal gyri) and posterior cingulate in OO and ASD groups, where both differed from the TD group. Furthermore, the OO group showed heightened "compensatory" activation in numerous left- and right-lateralized regions (left precentral/postcentral gyri, right precentral gyrus, left inferior parietal lobule, right supramarginal gyrus, left superior temporal/parahippocampal gyrus, left middle occipital gyrus) and cerebellum, relative to both ASD and TD groups. Behaviorally normalized language abilities in OO individuals appear to utilize atypical brain networks, with increased recruitment of language-specific as well as right homologue and other systems. Early intensive learning and experience may normalize behavioral language performance in OO, but some brain regions involved in language processing may continue to display characteristics that are more similar to ASD than typical development, while others show characteristics not like ASD or typical development.

Research paper thumbnail of Do Children and Adolescents with ASDs Who Have Achieved An Optimal Outcome Continue to Exhibit Pragmatic Language Deficits?

Research paper thumbnail of Residual Social and Communication Deficits In Optimal Outcome Children and Adolescents with a History of Autism Spectrum Disorders

Research paper thumbnail of Academic Functioning in Children with ASDs Who Have Achieved Optimal Outcomes

Research paper thumbnail of Sensory Responses in Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Semantic and Syntactic Language Skills In Individuals with Optimal Outcomes

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) reported small differences in language scores in OO compared to typically developing adolescents. Objectives: The current study examines semantic and syntactic language skills as measured on the Comprehensive Evaluation of Language Fundamentals (CELF-IV) in a small cohort of individuals once diagnosed with an ASD who have since lost their diagnosis, known as the “optimal outcome” (OO) group. The study compares performance in the OO group to performance...

Research paper thumbnail of Idiosyncratic Use of Language and Unusual References in Narratives of Optimal Outcome Children with a History of Autism Spectrum Disorders

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Objectives: The purpose of this study was to analyze narratives of individuals who have achieved “optimal outcomes” (OO) and contrast them with narratives of individuals with high-functioning autism (HFA) and typical development (TD), with a focus on idiosyncratic language and unusual references. Spontaneous narratives provide an especially sensitive method for investigating language abilities. Methods: The “Tuesday” story from the Autism Diagnostic Observation Scale (ADOS) was coll...

Research paper thumbnail of Linguistic Strengths and Weaknesses in Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Language Profiles of Individuals with a History of ASD Who Have Optimal Outcomes

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (OO; Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) found that their OO group showed some small, but notable differences in language scores compared to a typically developing group. Objectives: The current study examines language skills as measured on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF-IV), California Verbal Learning Test (CVLT), Comprehensive Test of Phonological Processing Nonword Repetition subtest (CTOPP NR), and Test of Language Competence (TLC) in a cohort of O...

Research paper thumbnail of Social Functioning in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

Background: A study is currently following children and adolescents who have a history of autism ... more Background: A study is currently following children and adolescents who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for the disorder. These individuals have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASD, achieve an "optimal outcome (OO)" (Sutera et al., 2007, Kelley et al., 2010, and Helt et al., 2008). Objectives: Despite no longer meeting diagnostic criteria for an ASD, OO individuals may exhibit subtle deficits in the social domain. This study examines social functioning by assessing autism symptomatology and adaptive skills in a group of OO individuals. Methods: The Autism Diagnostic Observation Schedule (ADOS) was conducted with 32 OO individuals (M(age)=12.9), 33 individuals with high-functioning autism (HFA) (M(age)=13.4), and 25 typically developing (TD) pee...

Research paper thumbnail of Neural Activation to Sentences in Individuals with High-Functioning Autism, Typical Development, and Autism Spectrum Disorder Optimal Outcome

Research paper thumbnail of Peers' Evaluation of Stories Told by Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Peer Ratings of Videotaped Story-Telling of Optimal Outcome Children with a History of ASD

Background: We are following children who have a history of autism spectrum disorder (ASD), who n... more Background: We are following children who have a history of autism spectrum disorder (ASD), who no longer meet diagnostic criteria for ASD. These children have achieved social and language skills within the average range, receive little or no school support, and are considered to have “optimal outcomes” (OO; Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). However, it is unclear how peers perceive OO children. Objectives: In a previous study, we asked naïve raters (aged 15-20) to rate transcribed narratives of stories told by children with OO, high-functioning autism (HFA), and typical development (TD) using the Tuesday book. Those results (reported at AACN 2013) indicated that OO and TD group stories did not differ, whereas HFA stories were harder to comprehend, contained more odd content, and were poorer in overall story quality. In the current study, high school peers rated videos of the narratives for “story goodness,” pragmatic language qualities, and glo...

Research paper thumbnail of Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

Journal of Autism and Developmental Disorders, 2015

Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who n... more Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth, ages 8-21, showed that OO and HFA groups had elevated current ADHD and specific phobias, with tics in HFA. In the past, the HFA group also had elevated depression and ODD, and the OO group had tics. The HFA group also showed subthreshold symptoms of specific and social phobias, and generalized anxiety. Psychopathology in the OO group abated over time as did their autism, and decreased more than in HFA.

Research paper thumbnail of Early Manifestations of Autism Spectrum Disorders

The Neuroscience of Autism Spectrum Disorders, 2013

Research paper thumbnail of Social Function and Communication in Optimal Outcome Children and Adolescents with an Autism History on Structured Test Measures

Journal of Autism and Developmental Disorders, 2015

Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We exam... more Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits, and were judged as likable as TD peers. Some group differences were found: OO youth had less insight into social relationships and poorer friendship descriptions than TD youth. OO participants had attention, self-control, and immaturity difficulties that may impact social abilities. However, OO participants were most engaged, friendliest, warmest, and most approachable. Overall, OO participants had no social and communicative impairments, although some exhibited mild social difficulties that often accompany attentional problems.

Research paper thumbnail of Screening Measures

Encyclopedia of Autism Spectrum Disorders, 2013

ABSTRACT DefinitionAutism screening is the process of administering a brief assessment to determi... more ABSTRACT DefinitionAutism screening is the process of administering a brief assessment to determine the level of risk for autism. This is usually done by giving parents a brief questionnaire or checklist about their child’s development, including social, language, motor, and cognitive development but can also be done by direct clinical observation. If concerns about a child’s development arise from the screening instrument, the child is referred for a more in-depth, diagnostic and developmental evaluation.Historical Background Autism spectrum disorders (ASDs) are severe disorders of development; the Centers for Disease Control reported prevalence rates as 1 in 110 in 2009 (Bertrand et al., 2001; Chakrabarti & Fombonne, 2001; Fombonne, Zakarian, Bennett, Meng, & McLean-Heywood, 2006). Evidence of neurobiological abnormalities in the first year of life (Courchesne, 2004) as well as retrospective evaluation of infant behavior (Baranek, 1999; Osterling & Dawson, 1994) ...

Research paper thumbnail of Language and Verbal Memory in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

Journal of Autism and Developmental Disorders, 2014

Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle... more Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the average range or above on all measures and showed few differences from the TD group. The HFA group performed within the average range but showed significantly lower mean performance than the other groups on multiple language measures, even when controlling for verbal IQ. Results also indicate that OO individuals show strong language abilities in all areas tested, but that their language may show greater reliance on verbal memory.

Research paper thumbnail of Ratings of Broader Autism Phenotype and Personality Traits in Optimal Outcomes from Autism Spectrum Disorder

Journal of Autism and Developmental Disorders, 2016

The study examines whether "optimal outcome" (OO) children, despite no longer m... more The study examines whether "optimal outcome" (OO) children, despite no longer meeting diagnostic criteria for Autism Spectrum Disorder (ASD), exhibit personality traits often found in those with ASD. Nine zero acquaintance raters evaluated Broader Autism Phenotype (BAP) and Big Five personality traits of 22 OO individuals, 27 high functioning individuals with ASD (HFA), and 23 typically developing (TD) peers. HFA children displayed higher ratings than their peers on all BAP traits. OO were indistinguishable from TD, with the exception of greater extraversion (e.g., increased talkativeness), a potential tendency to be less emotionally stable, and pragmatic language deficits such as getting sidetracked in conversation. Overall, OO individuals are not showing BAP characteristics, but may be subject to other mild ADHD-like characteristics.

Research paper thumbnail of Residual Communication and Social Deficits in Individuals with a History of Autism Spectrum Disorders Who Achieved Optimal Outcomes

Research paper thumbnail of Language comprehension and brain function in individuals with an optimal outcome from autism

NeuroImage: Clinical, 2016

Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individ... more Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO). The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as most participants with OO received years of intensive therapy that could alter brain networks to align with typical function or work around ASD-related neural dysfunction. Individuals ages 8 to 21 years with high-functioning ASD (n = 23), OO (n = 16), or typical development (TD; n = 20) completed a functional MRI scan while performing a sentence comprehension task. Results indicated similar activations in frontal and temporal regions (left middle frontal, left supramarginal, and right superior temporal gyri) and posterior cingulate in OO and ASD groups, where both differed from the TD group. Furthermore, the OO group showed heightened "compensatory" activation in numerous left- and right-lateralized regions (left precentral/postcentral gyri, right precentral gyrus, left inferior parietal lobule, right supramarginal gyrus, left superior temporal/parahippocampal gyrus, left middle occipital gyrus) and cerebellum, relative to both ASD and TD groups. Behaviorally normalized language abilities in OO individuals appear to utilize atypical brain networks, with increased recruitment of language-specific as well as right homologue and other systems. Early intensive learning and experience may normalize behavioral language performance in OO, but some brain regions involved in language processing may continue to display characteristics that are more similar to ASD than typical development, while others show characteristics not like ASD or typical development.

Research paper thumbnail of Do Children and Adolescents with ASDs Who Have Achieved An Optimal Outcome Continue to Exhibit Pragmatic Language Deficits?

Research paper thumbnail of Residual Social and Communication Deficits In Optimal Outcome Children and Adolescents with a History of Autism Spectrum Disorders

Research paper thumbnail of Academic Functioning in Children with ASDs Who Have Achieved Optimal Outcomes

Research paper thumbnail of Sensory Responses in Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Semantic and Syntactic Language Skills In Individuals with Optimal Outcomes

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) reported small differences in language scores in OO compared to typically developing adolescents. Objectives: The current study examines semantic and syntactic language skills as measured on the Comprehensive Evaluation of Language Fundamentals (CELF-IV) in a small cohort of individuals once diagnosed with an ASD who have since lost their diagnosis, known as the “optimal outcome” (OO) group. The study compares performance in the OO group to performance...

Research paper thumbnail of Idiosyncratic Use of Language and Unusual References in Narratives of Optimal Outcome Children with a History of Autism Spectrum Disorders

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Objectives: The purpose of this study was to analyze narratives of individuals who have achieved “optimal outcomes” (OO) and contrast them with narratives of individuals with high-functioning autism (HFA) and typical development (TD), with a focus on idiosyncratic language and unusual references. Spontaneous narratives provide an especially sensitive method for investigating language abilities. Methods: The “Tuesday” story from the Autism Diagnostic Observation Scale (ADOS) was coll...

Research paper thumbnail of Linguistic Strengths and Weaknesses in Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Language Profiles of Individuals with a History of ASD Who Have Optimal Outcomes

Background: A study is currently following children who have a history of autism spectrum disorde... more Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (OO; Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) found that their OO group showed some small, but notable differences in language scores compared to a typically developing group. Objectives: The current study examines language skills as measured on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF-IV), California Verbal Learning Test (CVLT), Comprehensive Test of Phonological Processing Nonword Repetition subtest (CTOPP NR), and Test of Language Competence (TLC) in a cohort of O...

Research paper thumbnail of Social Functioning in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

Background: A study is currently following children and adolescents who have a history of autism ... more Background: A study is currently following children and adolescents who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for the disorder. These individuals have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASD, achieve an "optimal outcome (OO)" (Sutera et al., 2007, Kelley et al., 2010, and Helt et al., 2008). Objectives: Despite no longer meeting diagnostic criteria for an ASD, OO individuals may exhibit subtle deficits in the social domain. This study examines social functioning by assessing autism symptomatology and adaptive skills in a group of OO individuals. Methods: The Autism Diagnostic Observation Schedule (ADOS) was conducted with 32 OO individuals (M(age)=12.9), 33 individuals with high-functioning autism (HFA) (M(age)=13.4), and 25 typically developing (TD) pee...

Research paper thumbnail of Neural Activation to Sentences in Individuals with High-Functioning Autism, Typical Development, and Autism Spectrum Disorder Optimal Outcome

Research paper thumbnail of Peers' Evaluation of Stories Told by Optimal Outcome Children with a History of Autism Spectrum Disorders

Research paper thumbnail of Peer Ratings of Videotaped Story-Telling of Optimal Outcome Children with a History of ASD

Background: We are following children who have a history of autism spectrum disorder (ASD), who n... more Background: We are following children who have a history of autism spectrum disorder (ASD), who no longer meet diagnostic criteria for ASD. These children have achieved social and language skills within the average range, receive little or no school support, and are considered to have “optimal outcomes” (OO; Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). However, it is unclear how peers perceive OO children. Objectives: In a previous study, we asked naïve raters (aged 15-20) to rate transcribed narratives of stories told by children with OO, high-functioning autism (HFA), and typical development (TD) using the Tuesday book. Those results (reported at AACN 2013) indicated that OO and TD group stories did not differ, whereas HFA stories were harder to comprehend, contained more odd content, and were poorer in overall story quality. In the current study, high school peers rated videos of the narratives for “story goodness,” pragmatic language qualities, and glo...

Research paper thumbnail of Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

Journal of Autism and Developmental Disorders, 2015

Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who n... more Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth, ages 8-21, showed that OO and HFA groups had elevated current ADHD and specific phobias, with tics in HFA. In the past, the HFA group also had elevated depression and ODD, and the OO group had tics. The HFA group also showed subthreshold symptoms of specific and social phobias, and generalized anxiety. Psychopathology in the OO group abated over time as did their autism, and decreased more than in HFA.

Research paper thumbnail of Early Manifestations of Autism Spectrum Disorders

The Neuroscience of Autism Spectrum Disorders, 2013

Research paper thumbnail of Social Function and Communication in Optimal Outcome Children and Adolescents with an Autism History on Structured Test Measures

Journal of Autism and Developmental Disorders, 2015

Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We exam... more Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits, and were judged as likable as TD peers. Some group differences were found: OO youth had less insight into social relationships and poorer friendship descriptions than TD youth. OO participants had attention, self-control, and immaturity difficulties that may impact social abilities. However, OO participants were most engaged, friendliest, warmest, and most approachable. Overall, OO participants had no social and communicative impairments, although some exhibited mild social difficulties that often accompany attentional problems.

Research paper thumbnail of Screening Measures

Encyclopedia of Autism Spectrum Disorders, 2013

ABSTRACT DefinitionAutism screening is the process of administering a brief assessment to determi... more ABSTRACT DefinitionAutism screening is the process of administering a brief assessment to determine the level of risk for autism. This is usually done by giving parents a brief questionnaire or checklist about their child’s development, including social, language, motor, and cognitive development but can also be done by direct clinical observation. If concerns about a child’s development arise from the screening instrument, the child is referred for a more in-depth, diagnostic and developmental evaluation.Historical Background Autism spectrum disorders (ASDs) are severe disorders of development; the Centers for Disease Control reported prevalence rates as 1 in 110 in 2009 (Bertrand et al., 2001; Chakrabarti & Fombonne, 2001; Fombonne, Zakarian, Bennett, Meng, & McLean-Heywood, 2006). Evidence of neurobiological abnormalities in the first year of life (Courchesne, 2004) as well as retrospective evaluation of infant behavior (Baranek, 1999; Osterling & Dawson, 1994) ...