New study shows importance of early diagnosis of autism spectrum disorders

A new study from the Society for Research in Child Development (SRCD) documents that visible differences in social communication for infants with autism spectrum disorder (ASD) manifest at 9 months, indicating a critical window for targeted intervention.

This research was funded by the National Institute of Mental Health, the National Institute of Deafness and Communication Disorders, the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National Institute of General Medical Sciences, Office of the Vice President for research at the University of South Carolina ASPIRE-I, the Marcus Foundation, the Joseph B. Whitehead Foundation, and the Georgia Research Alliance.

The basis of social communication is present from birth, with newborns preferring to orient themselves towards faces rather than non-faces and caregivers rather than strangers. Between 9 and 12 months, infants develop other social communication skills such as gazing, facial expressions, gestures and sounds. Differences in social communication are a defining characteristic of autism spectrum disorders.

However, there is little previous research examining whether observable prelinguistic social communication skills, before the age of 12 months, emerge more slowly in infants with ASD than in typically developing infants.

The study of social communication skills

First, it is important to note that within the autism community, an oft-explored topic uses First language identity versus first person language. Speaking with

Dr Jessica Bradshaw, Assistant Professor of Psychology at the University of South Carolina, regarding this study, she uses the term “autistic individual / child” instead of the language of identity (“autistic person”) because of the age of the children. infants and toddlers who she works with. However, Dr. Bradshaw uses the language of identity first in other contexts, especially because it is the language of choice for many adults with autism.

When asked what motivated this study, Bradshaw replied, “Children with autism are typically diagnosed between the ages of 2 and 4, with speech delays being one of the primary concerns of parents,” he said. she explains. “But I am very interested in understanding the course of autism development before this stage, in early childhood. Even before speech develops around the first birthday, many social communication behaviors emerge.”

Dr Bradshaw explained that speaking is normally the number one concern of parents of children with ASD, but other forms of communication develop rapidly in the first year of life, such as gestures and sounds.

“For example, around 9 months, infants communicate using gaze and facial expression,” she said. “Your 9 month old can even use gestures, like pointing and giving things away. These early milestones are the foundation of social and language development. In this study, I wanted to see if infants with autism exhibit different patterns of social communication. when these behaviors start to emerge, between 9 and 12 months. A full understanding of the developmental pathways that lead to autism can then support earlier detection and intervention. While we observed significantly less social communication skills during this time, there was also evidence for the presence of a small but fundamental set of skills for 9 month old infants with ASD that can be put to good use during this period. early intervention. “

Foresight, longitudinal social development study took place between 2012 and 2016 and included 124 infants (35% female, 84% Caucasian) who had a high or low familial likelihood of developing ASD. Participants included in this study were either diagnosed with ASD or confirmed development at 24 months.

The conclusions of the study

“The results show that being aware of changes in social communication between 9 and 12 months can be invaluable during this window of development,” said Abigail Delehanty, assistant professor and program director for the Language and Language Disorders Clinic. autism at Duquesne University. “Intervention studies for infants between 9 and 12 months are starting to emerge, and this study provides a rationale for starting to support communication development before the first birthday, as infants with ASD exhibit less communication behaviors. social and earn less during this period. “

This study shows that infants who would later be diagnosed with ASD already exhibit significantly less social and early speech skills than their typically developing peers at 9 months of age. However, only three months later, at 12 months, infants with ASD performed below almost all measures of prelinguistic communication.

Additionally, three unique patterns of social communication development have emerged for infants with ASD. First, communication with gaze, facial expression, and sounds were “consistently weak” from 9 to 12 months.

Second, the symbolic use of objects (eg, being creative with toys), although similar in the 9 month groups, was delayed in the 12 month ASD group.

Finally, gestures and the overall frequency of communication showed a “growing gap” for infants with ASD. These findings suggest very early social communication differences for infants with ASD that are clear and observable as early as 9 months of age and highlight specific areas of vulnerability and unique patterns of change.

The authors recognize several limitations to the research. Among them is the exclusion of a comparison group with non-ASD developmental delay. Additionally, due to the sample size, clinicians administering the communication assessment were not blinded by the family history of infant ASD, socio-demographic differences between diagnostic groups, and screening. diagnosis was made at 24 months rather than 36 months when the false negative rate is generally higher.

Early intervention and advocacy

Numerous studies have shown how effective early intervention can be for people with autism. More recently, researchers at Bar-Ilan University discovered that early diagnosis and therapeutic intervention to treat symptoms of ASD helped to avoid serious deviations in neurological development.

“The first three years of life are extremely important for an infant’s development,” says Bradshaw. “During this period, brain plasticity is at its peak. Early interventions may promote the emergence of social interaction and communication skills, especially for people with a high likelihood of developing autism. Additionally, many of these interventions have a parent or caregiver-mediated component, which means that parents learn to integrate intervention strategies into daily routines and interactions with their children. This is especially important during periods of time. infant and toddler years. “

If you are a parent of a child with autism, Bradshaw is hopeful this study will validate your concerns, no matter how much your worries grow. For many people with autism, the first signs can be subtle and difficult for pediatricians to detect during short visits to the child. Dr. Bradshaw encourages parents to voice their concerns to their health care providers and ask them to complete developmental or autism screening tests (eg, toddler checklist, ASQ or M-CHAT).

“In many states, parents can refer their child to the early intervention system on their own,” Bradshaw said. “Parents can also contact local specialists, such as developmental pediatricians or child psychologists. There are often long waiting lists for assessment and intervention services, so it is never too early to start the process. It is also important to remember that a diagnosis of autism is not always necessary to begin with services, especially in the first three years. Parents of children already diagnosed with ASD are invaluable resources. They have the best tips and tricks for navigating the system. “

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