Study: Children Can Be Diagnosed with Autism by Age One
BALTIMORE — July 3 /PRNewswire-USNewswire/
In a study published this week in the Archives of General Psychiatry, researchers from the Kennedy Krieger Institute in Baltimore, Maryland found that autism can be diagnosed at close to one year of age, which is the earliest the disorder has ever been diagnosed.
The study, which evaluated social and communication development in autism spectrum disorders (ASD) from 14 to 36 months of age, revealed that approximately half of all children with autism can be diagnosed around the first birthday. The remaining half will be diagnosed later, and their development may unfold very differently than children whose ASD is diagnosable around the first birthday. Early diagnosis of the disorder allows for early intervention, which can make a major difference in helping children with autism reach their full potential.
Researchers examined social and communication development in infants at high and low risk for ASD starting at 14 months of age and ending at 30 or 36 months (a small minority of the children exited the study at 30 months). Half of the children with a final diagnosis of ASD made at 30 or 36 months of age had been diagnosed with the disorder at 14 months, and the other half were diagnosed after 14 months. Through repeated observation and the use of standardized tests of development, researchers identified, for the first time, disruptions in social, communication and play development that were indicative of ASD in 14-month olds. Multiple signs indicating these developmental disruptions appear simultaneously in children with the disorder.
Dr. Rebecca Landa, lead study author and director of Kennedy Krieger‘s Center for Autism and Related Disorders, and her colleagues identified the following signs of developmental disruptions for which parents and pediatricians should be watching:
— Abnormalities in initiating communication with others: Rather than requesting help to open a jar of bubbles through gestures and vocalizations paired with eye contact, a child with ASD may struggle to open it themselves or fuss, often without looking at the nearby person.
— Compromised ability to initiate and respond to opportunities to share experiences with others: Children with ASD infrequently monitor other people’s focus of attention. Therefore, a child with ASD will miss cues that are important for shared engagement with others, and miss opportunities for learning as well as for initiating communication about a shared topic of interest. For example, if a parent looks at a stuffed animal across the room, the child with ASD often does not follow the gaze and also look at the stuffed animal. Nor does this child often initiate communication with others. In contrast, children with typical development would observe the parent’s shift in gaze, look at the same object, and share in an exchange with the parent about the object of mutual focus. During engagement, children have many prolonged opportunities to learn new words and new ways to play with toys while having an emotionally satisfying experience with their parent.
— Irregularities when playing with toys: Instead of using a toy as it is meant to be used, such as picking up a toy fork and pretending to eat with it, children with ASD may repeatedly pick the fork up and drop it down, tap it on the table, or perform another unusual act with the toy.
— Significantly reduced variety of sounds, words and gestures used to communicate: Compared to typically developing children, children with ASD have a much smaller inventory of sounds, words and gestures that they use to communicate with others.
“For a toddler with autism, only a limited set of circumstances – like when they see a favorite toy, or when they are tossed in the air – will lead to fleeting social engagement,” said Landa. “The fact that we can identify this at such a young age is extremely exciting, because it gives us an opportunity to diagnose children with ASD very early on when intervention may have a great impact on development.”
The current study reveals that autism often involves a progression, with the disorder claiming or presenting itself between 14 and 24 months of age. Some children with only mild delays at 14 months of age could go on to be diagnosed with ASD. Landa and her colleagues observed distinct differences in the developmental paths, or trajectories, of children with early versus later diagnosis of ASD. While some children developed very slowly and displayed social and communication abnormalities associated with ASD at 14 months of age, others showed only mild delays with a gradual onset of autism symptoms, culminating in the diagnosis of ASD by 36 months.
If parents suspect something is wrong with their child’s development, or that their child is losing skills during their first few years of life, they should talk to their pediatrician or another developmental expert. This and other autism studies suggest that the “wait and see” method, which is often recommended to concerned parents, could lead to missed opportunities for early intervention during this time period.
“What’s most exciting about these important advancements in autism diagnosis is that ongoing intervention research leads us to believe it is most effective and least costly when provided to younger children,” said Dr. Gary Goldstein, President and CEO of the Kennedy Krieger Institute and Chair of the Scientific Advisory Committee at Autism Speaks.
“When a child goes undiagnosed until five or six years old, there is a tremendous loss of potential for intervention that can make a marked difference in that child’s outcome.”
While there are currently no standardized, published criteria for diagnosing children with autism at or around one year of age, Landa’s goal is to develop these criteria based on this and other autism studies currently underway at the Kennedy Krieger Institute. Landa and her colleagues at the Institute plan on releasing preliminary diagnostic criteria for very young children with autism in an upcoming report.
Participants in the current study included infants at high risk for ASD (siblings of children with autism, n=107) and low risk for ASD (no family history of autism, n=18). Standardized tests of development and play-based assessment tools were used to evaluate social interaction, communication and play behaviors in both groups at 14, 18 and 24 months of age.
Researchers assigned diagnostic impressions at every age, indicating whether there were clinically significant signs of delay or impairment. After their last evaluation at 30 or 36 months, each participant was then given a final diagnostic classification of ASD, non-ASD impairment, or no impairment. The ASD group was further divided into an Early ASD diagnosis group and a Later ASD diagnosis group based on whether they were given a diagnosis of ASD at 14 or 24 months.
Read a Newsweek interview with Dr. Rebecca Landa.
Read coverage from USA Today.
Watch video from the Today Show.
BEHAVIORS TO LOOK FOR
- No single behavior is enough to diagnose autism, researchers say, but here are some signs to watch for at age 14 months:
- Lack of gesturing, vocalizing and eye contact to initiate communication.
- An inability to pick up cues from watching facial expressions. If a parent is looking at a stuffed toy, a typical child will follow the parent’s gaze to the toy. A child with autism often doesn’t do that.
- Unusual play patterns. A typical child given a toy fork will pretend to eat with it. A child with autism may repeatedly tap it on the table or pick it up and drop it.•
- Fewer words, gestures and sounds than typically developing children.
Source: Kennedy Krieger Institute
Study: Signs of autism show earlier in some children
By Anita Manning, USA TODAY
Children with autism can be identified as early as 14 months old, the youngest age at which the disorder has been diagnosed, a study by researchers at the Kennedy Krieger Institute in Baltimore suggests.
But about half the time, symptoms may not show up until months later. That suggests at least two distinct paths leading to autism: one that starts early in life and one in which a child seems to develop normally and then regresses, losing language and social skills.
Results of the study, the first to follow toddlers from 14 months until they turn 3, could allow earlier treatment to reduce the effects of autism, says Rebecca Landa, lead author of the report published in the Archives of General Psychiatry.
The range of developmental impairments known as autism spectrum disorders, or ASD, is marked by an inability to communicate and interact with others. Its cause is not known, but most researchers believe genetic factors play a role.
Most studies have relied on interviews with parents and examinations of family videos to look for early signals, such as a child’s lack of response to his name or failure to engage with others.
Scientists know that “we can reliably diagnose autism at age 2, but only by real experts,” Landa says. “What’s different about this is we can show that we can stretch that down close to the first birthday, but the caveat is we can’t do it for all children.”
The study involved 107 children who were considered at high risk for autism because they had a sibling with the disorder and 18 low-risk children who had no family history of autism.
Behavior differences in those with and without ASD at 14 months can be seen in videos that show toddlers interacting with a researcher.
“In one, a normally developing boy reacts happily when given a toy penguin, gives it to the researcher and laughs when she hands it back. “He integrates looking, giving and smiling,” Landa says.
“That is what I call the package, and the package is very seldom seen at 14 months of age in kids who have ASD.”
By contrast, a boy later diagnosed with autism shows only mild interest when a researcher uses a blanket to play peek-a-boo. He focuses briefly on the blanket, but he doesn’t interact with the researcher and soon loses interest.
Children in the “late-diagnosis group” behave at 14 months old very much like the children who didn’t end up with autism, Landa says. But from 14 to 24 months of age, there was a progressive decline in social development. “Whatever is happening, it’s affecting brain development in a way we can observe behaviorally,” she says. “We can’t watch the neurons making connections, but we can watch a child’s smile disappear.”
Landa cautions parents not to be overly alarmed if a child occasionally exhibits a worrisome trait. Autism involves many developmental disruptions that continue over time.
“I don’t know any children who don’t do weird things” now and then, she says. “If it’s going to be ASD, it’s going to stick.”
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.