1 11 General introduction Retrospective studies primarily depend on parents’ recollections of their child’s behavior during infancy, while prospective studies in the field of ASD research involve tracking the development of baby siblings deemed at a high likelihood for ASD due to having an older sibling diagnosed with the disorder. Prospective studies offer the field pivotal insights in how ASD unfolds from birth to later in life by identifying early markers and precursors (Lord et al., 2022; Jones et al., 2014). A summary of both early precursors and clinical indicators of ASD in the first years of life is presented below (see Box 1.2. for clinical case illustrations) 1. Social communication and interaction After the first birthday deficits in social communication and interaction tend to become more pronounced compared to the first twelve months. Social attention and social communication behaviors that can indicate development of ASD include reduced responsiveness to one’s name being called, less frequent use of communicative gestures (for example: waving, pointing), limited social smiling, less variety of facial expressions and limited shared enjoyment (Jones et al., 2014; Miller et al., 2017; Volkmar et al., 2005; Zwaigenbaum et al., 2015). One of the first and most frequent initial parental concerns are delays in the child’s speech and communicative development (Estes et al., 2015; Zwaigenbaum et al., 2005). Additionally, toddlers who were subsequently diagnosed showed a reduced attention towards socially meaningful stimuli (Dawson et al., 2004). Joint attention refers to the development of specific skills that enables one to share attention with others through pointing, showing, and coordinating looks between objects and people (triadic joint attention). Various research demonstrates that toddlers with ASD show fewer joint attention behaviors (Franchini et al., 2019; Sullivan et al., 2007). © P. Brouwers Note. These pictures illustrate a reduced interest in socially meaningful stimuli and limited social smiling
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