Early Indicators of Autism in Infants: Development of the IMES Screening Tool

Barbara B. Demchick, Joanne Flanagan, Chih Ying Li, Rachel Cassidy, Jessica Golding

Research output: Contribution to journalArticlepeer-review


We developed the Infant, Motor, and Engagement Scale (IMES) to address the public health goal of early identification of autism spectrum disorder (ASD). The IMES is a screening tool that assesses quality of infants’ interaction with people and objects during early play. We aimed to examine the IMES’ preliminary psychometric properties and its value in discriminating between infants later diagnosed with ASD and typically developing infants. We used the IMES to score retrospective home videos of 15 male infants, 7 who were later diagnosed with autism. We examined interrater reliability using Cohen’s Kappa, internal consistency with Cronbach’s alpha and content validity through expert review. Preliminary data support validity and reliability of the IMES for early identification for infants at 6 to 9 months. With further research, the IMES has the potential to identify at risk infants at a young age that may have long-term impact on child and family outcomes.

Original languageEnglish (US)
Pages (from-to)255-263
Number of pages9
JournalOTJR Occupation, Participation and Health
Issue number2
StatePublished - Apr 2023


  • autism
  • engagement
  • evaluation
  • pediatrics
  • play

ASJC Scopus subject areas

  • Occupational Therapy


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