We designed developmental delay (DD) and typical development (TD) as non-ASD groups. Toddlers with ASD and DD were randomly recruited from the inpatients or outpatients in Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University in Guangzhou between April and November 2017. Meanwhile, we recruited toddlers with TD from the nearby community during the same period. Toddlers with ASD (n = 61) were matched on chronological age to toddlers with DD (n = 31) and TD (n = 33), aged 16–30 months. The chronological age of children with ASD was 25.16 (3.71) months, and the sex ratio of men to women was 5.1:1. The chronological age of children with DD was 25.09 (3.68) months, and the sex ratio in this group was 5.2:1. The chronological age of children with TD was 24.73 (3.37) months, and the sex ratio was 5.6:1. There were no significant differences in chronological age and sex ratio among the three groups (all P-values > 0.05).
Toddlers with ASD were included to meet the diagnostic criteria of the diagnostic and statistical manual of mental disorders-the 5th edition (DSM-5) (20 (link)). Exclusionary criteria for toddlers with ASD included the following: (1) symptomatic autism, such as Rett syndrome, Fragile X syndrome, Angelman syndrome, and Prader–Willi syndrome, which were caused by known genetic defects or inherited metabolic diseases; (2) hearing impairment and moderate-to-severe sensory impairment; (3) cerebral palsy and poorly controlled seizures. The diagnosis of ASD in this study required a coincident diagnosis by two clinicians to ensure the quality and validity of the diagnosis.
Inclusion criteria for toddlers with DD included the following: (1) isolated developmental delay (involving single domain); (2) multiple developmental delays—two or more domains or developmental lines affected; (3) global developmental delay (GDD)—significant delay in most of the developmental domains (21 ). Exclusionary criteria for toddlers with DD included the following: (1) physical disabilities; (2) hearing impairment; (3) a history of serious brain diseases at birth, such as hypoxic ischemic encephalopathy and neonatal apoplexy.
Toddlers with TD were assessed by professional staff before the study, which did not have any confirmed or suspected developmental disorders in healthcare facilities. Exclusion criteria for toddlers with TD were as follows: (1) hearing impairment; (2) visual impairment; (3) speech and vocal impairment; (4) motor impairment due to any physical disability.
Toddlers with ASD were included to meet the diagnostic criteria of the diagnostic and statistical manual of mental disorders-the 5th edition (DSM-5) (20 (link)). Exclusionary criteria for toddlers with ASD included the following: (1) symptomatic autism, such as Rett syndrome, Fragile X syndrome, Angelman syndrome, and Prader–Willi syndrome, which were caused by known genetic defects or inherited metabolic diseases; (2) hearing impairment and moderate-to-severe sensory impairment; (3) cerebral palsy and poorly controlled seizures. The diagnosis of ASD in this study required a coincident diagnosis by two clinicians to ensure the quality and validity of the diagnosis.
Inclusion criteria for toddlers with DD included the following: (1) isolated developmental delay (involving single domain); (2) multiple developmental delays—two or more domains or developmental lines affected; (3) global developmental delay (GDD)—significant delay in most of the developmental domains (21 ). Exclusionary criteria for toddlers with DD included the following: (1) physical disabilities; (2) hearing impairment; (3) a history of serious brain diseases at birth, such as hypoxic ischemic encephalopathy and neonatal apoplexy.
Toddlers with TD were assessed by professional staff before the study, which did not have any confirmed or suspected developmental disorders in healthcare facilities. Exclusion criteria for toddlers with TD were as follows: (1) hearing impairment; (2) visual impairment; (3) speech and vocal impairment; (4) motor impairment due to any physical disability.
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