Autism detectable in first two to six months
According to a new study from Emory University in Atlanta published this week in the journal Nature, while autism and related disorders are usually diagnosed in toddlers between the ages of three and five years, infants as young as two months begin to exhibit declining eye contact and facial recognition by following eye-movement patterns associated with a later diagnosis of autism.
The small study of 110 American infants, published Tuesday, assessed how those at high risk for Autism Spectrum Disorders (those with siblings who had received similar diagnoses) were able to follow facial cues and make eye contact with caregivers, compared to low-risk infants (those with no relatives who had been diagnosed with ASD).
Dr Warren Jones of Emory's Marcus Autism Center and his colleague Ami Klin used specially designed eye-tracking technology to follow the gaze patterns of infants at ten stages of development, starting from two months through 24 months. They showed the children videos of “mom” or caregiver-like figures, and tracked eye-movement patterns across the screens.
While children who were later deemed developmentally typical paid increasingly more attention to faces and made more eye contact with caregivers during the first 18 months of life, Jones’ team found that the children confirmed to have an Autism Spectrum Disorder at a later age displayed markedly different eye-fixation patterns.
“What we found was that infants later diagnosed with autism looked less and less at mom’s eyes over time. They showed a steady decline in eye-looking from two to 24 months of life – and that decline was already happening within the first six months of life,” Jones said.
But what is encouraging, he added, is that some level of typical eye-fixation is found even in infants who later receive an ASD diagnosis.
This study “tells us that the unfolding of social disability is already happening at an early age, but it does also tell us that some of the attention to the eyes [and faces] of others – which we think of as a basic, early adaptive action – is there. And more of it is there than we expected to find. This gives us hope that in the future, if we could identify children with ASD at early points, we could intervene in ways that could build on that foundation of eye-contact” and facial recognition skills, Jones said.
Rebecca Landa, the director of Kennedy Krieger Institute's autism center, called Jones and Klin’s study “quite promising,” though preliminary.
“More research is needed using [this same] methodology to determine the sensitivity and predictive value of specific gaze patterns for an ASD diagnosis, and to find out how stable these atypical gaze patterns are in children with and without ASD,” she said. For instance, further studies may want to focus on children who do not have family history of autism spectrum disorder, to see if they display the same early-onset facial and eye-contact avoidance patterns.
“Finding early markers of ASD is very important because early intervention could have a profound positive impact on neural and behavioral development and, thus, improve outcomes of at risk children,” Landa added. “These new findings provide leads for researchers attempting to identify mechanisms that cause derailment in development.”
Early intervention is the eventual hope of Jones and colleagues, who are now running a second generation study using their same methodology. The next round is set to include over 300 children and is currently under way.
As a note to parents, Jones stressed that the eye-movement patterns analysed in his study cannot be detected with the naked eye by parents, and that more research is needed before any diagnostic tools or interventions can be made widely available.
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