Researchers use an eye-tracking technique to determine communication skills as part of an early diagnosis system.
A new experimental study suggests doctors might be able to detect signs of autism spectrum disorder (ASD) in children as young as 10 months.
Researchers have been working on methods to detect autism in children as young as 18 months. This new study, led by scientists at Uppsala University in Sweden, would represent a breakthrough.
Researchers studied a group of 112 infants: 81 had a family history and, therefore, a higher chance for autism, and 31 had a lower chance for autism.
Researchers used an eye-tracking technique to gauge the babies’ responses and initiative in interacting with visual stimuli and their parents.
By comparing babies’ results to diagnoses of autism at age 3, the researchers were able to determine that children who were less likely to seek contact with an adult via these visual measures were also more likely to have autism symptoms.
To understand why this approach might work, it helps to understand a little bit about how infants in their preverbal states communicate.
Before a baby can talk or even has the motor control to direct an adult’s attention by pointing, they use their eyes.
They can see an adult following their gaze and try to draw the adult’s attention to something that interests them by darting their eyes back and forth to the object of interest until both are engaging.
This shared attention — which researchers call “joint attention" — is a sign of a baby’s engagement with others.
What the researchers found was that, on average, babies who later received an autism diagnosis were less likely to initiate this joint attention than babies without autism.
“The results indicate that children with autism do not take as much initiative to communicate with adults as normal when they are infants,” said Terje Falck-Ytter, PhD, an assistant professor in the department of psychology at Uppsala University in Sweden and a lead researcher on the study.
These findings could lead to more helpful diagnostic tools for autism ASD in the future.
“The eyes have it. Parents and clinicians have long recognized alterations in eye gaze and eye contact as a risk factor for the later development of ASD in infants and toddlers,” Dr. Raun D. Melmed, a developmental and behavioral pediatrician and co-founder and medical director of the Southwest Autism Research and Resource Center in Phoenix, told Healthline.
“The capacity to accurately diagnose ASD prior to the child’s first birthday has been the goal of much research. Will it be in tests of eye gaze? Metabolic markers? Changes in EEG patterns? The answers are not yet there, but this type of research is promising, and for me has validity," he added.
That said, further clinical trials and replications of this study are necessary before these findings could be put to practical use.
An ASD diagnosis is only one part of the puzzle.
The question then becomes: What to do with that diagnosis?
“An early diagnosis may help parents better understand their child’s medical situation and give them more time to learn how to help their child flourish, and early intervention sets the course for treatment interventions where necessary,” Jim Laughman, president of Intellectual and Developmental Disabilities Solutions at AmeriHealth Caritas, told Healthline.
But those aren’t the only considerations.
“The autism spectrum is wide,” he said. “Does early diagnosis and intervention lead to increased stress and anxiety for parents, caregivers, and child care providers? What if the child is misdiagnosed?"
“Outcomes are better when we can take advantage of the enormous learning potential evident in the first two years of life,” he said. “But caution is advised, as in the excitement to diagnose early, some infants might be inaccurately identified, which can lead to a great deal of unnecessary stress for families.”
Missing from much of the research and recommendations on early autism interventions are the voices of people in the autistic community themselves.
“When considering intervention for a child today, we should be asking: Is this going to help the child, and help the child feel good about herself, or is it for the parents? The answers should be reviewed anytime things change,” John Elder Robison, author of the My Life With Asperger’s blog for Psychology Today, wrote in a post.
Robison writes that while he supports interventions for children with ASD with “visible impairments,” he doesn't for those who are merely eccentric in their behavior.
“Knowing an infant is 'developing autistically' is probably not enough to choose an intervention or even to know if one is needed,” he said. “How autistic? In what ways? The last thing we need is to hammer kids with possibly unneeded interventions that may harm as many as they help.”
At any rate, experts say it’s too soon to make any recommendations based on this specific study.
“The researchers acknowledge that the work they have produced needs further investigation,” Laughman said. “So, while the study meets scientific rigor, it is one study.”