April is Autism Awareness Month. Autism spectrum disorders (ASDs), which affect approximately 1 in every 150 individuals, can have a range of symptoms, including impairments in social interaction, communication issues and repetitive, inflexible behavior. ASDs are lifelong disorders, believed to be congenital, or present at birth, and are highly heritable.
It seems like most people these days are at least aware of autism, thanks to celebrity "experts" such as Jenny McCarthy or remarkable individuals like Temple Grandin who have opened up about their own autism.
However, most people might not be aware of many details about autism, such as the difficulty of diagnosing young infants and children with ASDs. Parents of children with ASDs generally identify concerns by the age of 12 to 18 months, but in the U.S., the average age of official diagnosis is around 4 years of age, with children in some socioeconomically disadvantaged groups diagnosed even later. The American Academy of Pediatrics recently recommended that all 18- and 24-month-olds be screened for ASDs. However, a big obstacle is that the scientific community still knows very little about early identification of and intervention for ASD in babies and toddlers.
The majority of the first ASD baby studies were "retrospective" – scientists asked parents of children already diagnosed to try to remember early signs of their children's autism. Most parents remembered things like delayed speech and language and disruptions in social communication that usually took place during the second year of life. But these studies still left a lot of questions in the air. Are there markers of differences in social communication earlier in life? How do we design studies to measure ASD in babies who can't talk? How do we know which babies to test?
Because ASDs are highly heritable researchers can identify infants who are high-risk for ASD (i.e., they have older siblings diagnosed with ASD) and those at low-risk (i.e., no diagnosed siblings). Researchers test these two groups of babies early in life and continue to follow them until they are old enough to be diagnosed with ASD themselves; statistical modeling is used to identify infant behaviors that predict a later ASD diagnosis.
What do we look for?
Typically developing babies show a natural preference for social interaction and prefer to look at the faces and eyes of other people. Three independent research groups have used eye-tracking systems to measure gaze patterns of infants while they watch videos of social scenes. Babies who were eventually diagnosed with ASD showed normal eye gaze when they were 2 months old, but showed declines in eye gaze to social scenes and faces between 2-12 months. In some babies, the decline over time was very early, subtle and gradual, making it very difficult for parents to detect and report.
This is all very promising. However, there is still a lot of work to be done before scientists can bring very early predictors into your pediatrician's office. To date, there are no evidence-based interventions available for babies who may be at-risk for ASDs. But there is hope! Studies on early ASD diagnosis and clinical trials of interventions are underway. If you are concerned about your baby, always talk to your pediatrician during well-child visits, and continue to advocate for your baby as he/she nears the age at which existing ASD screenings can be used (18-24 months).
For some excellent online resources, visit www/nimh.nih.gov/Health/topics/autism-spectrum-disorders-pervasive-developmental-disorders and www.autismspeaks.org.
Cognitive psychologist Tonya Bergeson-Dana combines her real world experience as a mother with her professional training as a researcher to provide parents with a practical way to apply the most current findings in childhood development research to their everyday life. Tonya welcomes questions and feedback from readers and can be contacted at firstname.lastname@example.org.