The causes of autism are still unclear, but evidence is building that early intervention — before age 1 — may help mitigate or even prevent the developmental disorder from occurring in the first place. Making such early treatment more possible, researchers now report a promising new way of detecting autism in infants as young as 14 months.
Neuroscientist Karen Pierce, director of clinical research at the University of San Diego’s (UCSD) Autism Center of Excellence, found that autism can be predicted by identifying young babies who have a preference for repetitive geometric patterns. Pierce and her team studied 110 babies — some showed signs of autism spectrum disorders, some exhibited symptoms of other developmental abnormalities, and about half were developing normally. Babies sat on a parent’s lap and were presented with two 1-min. videos, played side by side. One video showed children stretching or dancing in a yoga class, while the other showed abstract geometric shapes changing in a repetitive pattern. Among the toddlers aged 14 months to 42 months, 100% of those who spent more than 50% of the time watching the geometric shapes were autistic.
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“Only the babies who were autistic — who either had the diagnosis of autism or became autistic — looked at the geometric pattern,” says Pierce. “So far this is the only marker for autism that is reliable.”
While the test succeeded in accurately picking up only the autistic children, it failed to identify all children with autism. That is, it missed some cases of autism among the study population, because some of the babies who were eventually diagnosed with the mental disorder did not prefer the geometric patterns early on. Overall, 40% of autistic babies in the study showed the preference. “This test is not going to catch every case, but if it does catch you, it’s never wrong,” says Pierce, whose study was published Monday in the Archives of General Psychiatry.
The findings build on earlier evidence suggesting that even at very early ages, autistic children tend to be attracted to nonsocial and repetitive stimuli, such as inanimate objects and patterns. In contrast, typically developing infants gravitate toward social stimuli, such as human voices and faces. Some studies have found that autistic children even prefer listening to a computer generated sound over a mother’s voice, and that they pay more attention to a picture of a toy than to a face.
Dr. Geraldine Dawson, chief scientific officer of the research and advocacy group Autism Speaks and a professor of psychiatry at University of North Carolina at Chapel Hill, says that changes in the brains of these infants occurring between 6 and 12 months may trigger the switch in behavior. Until that age, even autistic babies will engage with their parents and respond to human interaction; after this period, their responses start to change, and it’s not clear why.
Tests such as the one Pierce describes could provide a new way of identifying children who are on the autism trajectory as close to this critical period as possible. That’s important, says Pierce, because studies show that intervening early in the course of the disorder can minimize and potentially even prevent autism from occurring at all. At UCSD, doctors have begun treating infants as young as 15 months, and shown success in improving language and social skills in toddlers diagnosed with autism. “The brain is plastic when it’s young, really malleable and receptive to the environment,” Pierce says. “The idea with early intervention is that if you can get in there and train the child to try to get social behavior more in line with normal development, and language behavior more in line with normal development, then it will help to generate more of these normal connections and counteract autism.”
If the results of her study are replicated, Pierce envisions a simple version of her test being used in doctor’s offices. Physicians can present young babies with side-by-side videos and monitor which one captures the infant’s attention more. In current practice, doctors must tell parents who are concerned about their baby’s development to “wait and see” until about age 2, when toddlers’ language skills — and clearer symptoms of autism — should emerge. But with the new test, they may not have to wait that long. “The benefit of being able to detect infants at risk of autism very early is that we can engage the baby early on and draw their attention to the social world,” says Dawson. “In that way, we may even be able to alter the trajectory of brain development and change the outcome of whether they develop autism or not.” That would certainly be a welcome goal.