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Researchers Find First Signs of Autism Even in Infancy

Show the average 14-month-old baby a sealed jar of cookies, and you get
some pretty predictable behavior. The child will reach for the treats
and, when thwarted, look beseechingly at the nearest adult. The request
for help — delivered with eye contact, gestures and often with pleading
sounds — is unmistakable. But some babies don't do it. One little boy,
captured on video by psychologist Wendy Stone at Vanderbilt University,
repeatedly places a researcher's hand on the cookie jar but never once
looks at her face to see why she isn't responding. Eventually,
tragically, he gives up.

Show the average 18-month-old a video of toddlers at play, and you
can bet that the tot will be mesmerized by scenes with strong emotion:
a fight or kiss. But some babies have other interests. At the Yale
Child Study Center, psychologists Warren Jones, Ami Klin and Sarah
Shultz measure when toddlers stop blinking — a reliable indicator of
rapt attention. The typical child will stare at the scene of a kiss,
but a child with autism will be transfixed by the opening and closing
of a door. (See six tips for traveling with an autistic child.)

Experiments like these, presented at a recent conference at Columbia
University's Teachers College, are helping researchers identify the
signs of autism at ever earlier ages. For parents, says Stone, director
of Vanderbilt's Treatment and Research Institute for Autism Spectrum
Disorders, "the average age of first concern is 17 months, though a
diagnosis isn't typically made until age 3. That's a long time to be
concerned and not know what to do."

In 2007, the American Academy of Pediatrics recommended that doctors
begin screening babies for autism at 18 months, but researchers have
yet to refine the tools for making a reliable diagnosis at that age.
One issue, says Catherine Lord, director of the University of Michigan
Autism & Communication Disorders Center, is that there is so much
individual variability in how babies develop. Another challenge is that
many of the signature signs of autism — delayed speech, repetitive
movements or fixations on particular toys or objects — involve language
and motor skills that babies have not yet acquired. That's why
identifying the signs of autism before age 2 often involves the absence
of typical behavior as opposed to the presence of aberrations.

Among the telltale signs of trouble at 12 months: not responding to
one's name; not sharing interests through pointing and eye gaze; lack
of joyful expression; an absence of babbling; difficulty establishing
eye contact; and staring too long at inanimate objects (see FirstSigns.org
for more early-warning signs). Investigators have identified these
red-flag signs of autism by looking at early home videos of children
who were diagnosed at age 3 or later and by studying the younger
siblings of children with autism, who have relatively high rates —
perhaps 15% — of the disorder. But no single behavior is indicative,
and researchers believe that rather than being given a definitive
diagnosis, tots with several of these behaviors should be identified as
"at risk" and referred to early-intervention programs. (See pictures of a school for autistic children.)

Research strongly suggests that early intervention is key to
improving outcomes for at-risk children. And by identifying these
children at younger ages, scientists can better determine which aspects
of autism are hardwired and which are the secondary results of living
with the disability. There is also growing support in the
autism-research community for the view that a significant number of
children who are at risk could be protected from becoming fully
autistic if they are assisted early enough and given the optimal
intervention.

"The environment in the early years has an active role in shaping
the brain," says Geraldine Dawson, a leading autism researcher and the
chief scientific officer of the advocacy group Autism Speaks. "What we
see in autism may be partly the result of not engaging with the social
environment. So if you engage the baby through an intervention, you
might prevent or at least reduce the development of autism symptoms." (See more about autism.)

Thus, the child who is not taking part in the typical parent-child
dance — exchanging smiles and glances, pointing at something of
interest, seeking attention — is missing out on a lot of learning and
failing to lay the foundations for more complex social behavior. Rather
than become experts on social cues, as most humans are wired to do,
these children, observes Klin, tend to focus on the physical world —
the opening and closing of doors and the properties of inanimate
objects.

Several studies from across the country are looking at how to draw
at-risk infants into the social world so that they will develop more
normally. One National Institutes of Health–funded study, at the
University of Washington, begins intervention for at-risk babies at 8
months, says Dawson, who adds, "What we are doing is teaching the
parents how to structure interactions to promote eye contact and
babbling." Parents learn, for example, to engage their babies in
settings where there are few distractions so that facial expressions
and language are more salient. They also learn strategies to calm
infants who tend to become agitated and stressed by social activity.
The intervention is playful in spirit, says Dawson, adding, "Parents
get very confident and are able to learn this quickly." The hope, she
says, is that for some significant portion of children at risk, "we can
begin before the full autism syndrome is present and prevent it from
emerging."

LINK: http://www.time.com/time/health/article/0,8599,1895357,00.html