Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
This paper tests the structure of the First Years Inventory (FYI 3.1), a measure of social communication (SC) and sensory regulation (SR) and whether the structure varies over age; data collection was done on a community sample of 1,893 children between 8 and 16 months old. Results provided support for eight factors, three SC and five SR. There is evidence that the overall structure holds over the range of ages assessed, with some variability in factor loadings and between-factor correlations.
Primary Author and Speaker: John Sideris
Contributing Authors: Yun-Ju Chen, Linda Watson, Elizabeth Crais, and Grace Baranek
PURPOSE: Current estimates of the prevalence of ASD in children in the United States indicate the rate as high as 1.7% (Baio, et al., 2018) and increasingly there have been calls for early detection and intervention. The previous version, the FYI 2.0 (Reznick, et al., 2007) had have only been validated as young as 12 months. The FYI 3.1 (Baranek, et al., 2013) is an expansion of the FYI 2.0 both in scope and in age range. In this study, we evaluated the reliability of sensory regulatory and social communication factors as measured by the FYI 3.1, the strength of the association between items and these factors, and the relationships of these factors to each other. Finally, we tested the changes in these associations and relations as a function of child age.
DESIGN: Respondents were recruited through North Carolina vital records in order to reach a broad community sample of parents of children between the ages 8 and 16 months; data were collected online or by mail by the. Diagnostic assessments were done at 3 years of age for 1893 children, 67 (3.5%) of whom were classified with ASD. Subjects were grouped in to three age blocks: 8 to < 11 months (N = 591), 11 to < 14 months (N = 940), and 14 to < 16 months (N = 362) for analysis. The FYI 3.1 is a 68-item measure. To reduce respondent burden, two short forms were created each with 47 items, with 26 common across the two. Items on the scale are grouped into two domains, Sensory-Regulatory (SR) and Social-Communication (SC). Each item asks parents about a specific behavior with five response categories ranging from ‘Never' to ‘Always.'
METHOD: We applied exploratory and confirmatory factor analytic models to build and test the underlying structure of the measure. We required at least three items per factor and each item was restricted to load on a single factor. Given the planned missingness in the data, the models were fit using maximum likelihood estimation, which provides reliable of parameters under these conditions. Given expected differences, we tested for change in the structure of the scale as a function of age.
RESULTS: The results supported an eight-factor structure with good model fit (RMSEA < .028, CFI > .84), with five factors in the SR domain (Hyporesponsiveness, Sensory Interests, Repetitions, and Seeking (SIRS) behaviors, Hyperresponsiveness, Sleeping, & Feeding) and three in SC (Initiating Interaction & Communication, Imitation & Play, and Social Responsivity). Factor loadings across all factors were significant and strong; the majority of loadings had standardized values greater than .4. Between factor loadings tended to be higher within domains (SR and SC) than across. There was evidence of some change in item parameters as a function of age and between-factor correlations varied over age.
CONCLUSION: These results provide evidence for the structure of an updated version of the FYI that measures SR and SC factors. This update not only provides more precise measurement of these features, but expands the assessment to span from 6 to 16 months.
IMPACT STATEMENT: Evidence for efficacy of early screening for ASD is inconclusive (USPSTF: Siu, et al., 2016). These results provide evidence for the reliability of FYI 3.1 and lay the groundwork for its use as a screening measure. A formal validated screener could facilitate OTs’ ability to refer for earlier diagnostic assessment for ASD and provide specific parental support.
References
Baio, J., Wiggins, L., Christensen, D. L., -¦ Dowling, N. F. (2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C.: 2002), 67(6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1
Baranek G. T., Watson, L. R., Crais E., Turner-Brown, L., & Reznick S. (2013) First Years Inventory (FYI) 3.1. Chapel Hill, NC: University of North Carolina at Chapel Hill.
Johnson CP, Myers SM; American Academy of Pediatrics Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215. https://doi.org/10.1542/peds.2007-2361.
Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., ... & Krist, A. H. (2016). Screening for autism spectrum disorder in young children: US Preventive Services Task Force recommendation statement. Jama, 315(7), 691-696.
