Social-communicative gestures at baseline predict verbal and nonverbal gains for children with autism receiving the Early Start Denver Model

In children with autism spectrum disorder, atypical gesture use is a core deficit with consequences for social learning, social interaction, and language development. Little is known about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. We found that the parent-rated "Gestural Approach Behavior" subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with developmental changes after 1 year of intervention as assessed by the Mullen Scales of Early Learning. This subscale was as strong a predictor as the Mullen nonverbal development quotient before intervention. Our findings suggest that children who use more gestures for social communication might be better equipped to respond to the learning opportunities offered by the Early Start Denver Model. Lay abstract Although there is growing evidence of the effectiveness and importance of certain early intervention programs for children with autism spectrum disorders, little is known about predictive information before intervention to search for the most accurate therapeutic approach for the individual child and his family. In children with autism spectrum disorder, atypical gesture use is one core deficit with consequences for the development of social interaction and language, but there is little knowledge about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. In this study, we found that the parent-rated "Gestural Approach Behavior" subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with clinically assessed developmental changes after 1 year of intervention. This subscale was as strong a predictor as nonverbal development before intervention. Our findings suggest that children who use more gestures in daily life might be better equipped to respond to learning opportunities offered by early interventions targeting social communication strategies such as the Early Start Denver Model. Furthermore, we conclude that the parent-rated questionnaire might be a valuable and economic set of questions with high relevance for clinical assessments.