In a previous article I wrote about the diagnosis of autism vs. Asperger’s Syndrome. One of the points I made about diagnosing autism spectrum disorders is that there is no medical test to identify autism. Well today I am here to eat my words. It seems that earlier this month some scientists have used neurological brain imaging or MRI’s to detect autism in infants as young as six months. In this post we are going to compare the results of this study with more traditional behavioral check-lists to detect the early warning signs of autism.
What did the brain imaging research show?
Researchers from the University of North Carolina wanted to examine brain development in babies at risk for developing autism. Autism is thought to have a genetic component so the study authors chose 92 infants who had older siblings diagnosed with autism spectrum disorder as their subjects. These at-risk babies had a special type of MRI called diffusion tensor imaging which would show brain changes, particularly in the white matter of the brain over time. This procedure was performed at intervals of 6 months, 1 year, and 2 years of age. Of the 92 infants who were scanned, 28 would later be diagnosed with autism.
In babies later diagnosed with autism, the brain scans revealed differences in white matter development than babies without autism. These differences were noted as early as six months of age. Specifically, the white matter of babies who developed autism was more dense than normal but by two years the neural pathways were less dense than typically developing toddlers. This study shows lends credence to the theory that autism is a brain disorder which begins early in infancy.
You may read the original study in the American Journal of Psychiatry.
What are some of the implications of this new research?
In some ways this study seems to validate what I have always said about my son Max who has autism. I have always explained his autism as: He is wired up differently. And these differences in his neurological hard wiring may have begun before we could detect any signs of his being off track in his development.
At this point in time the researchers of this study warn that an MRI is not yet a diagnostic test for autism. One of the shortcomings of this research, as presented by the study authors, is that the subject pool was limited in that it only included infants who were identified as being at high risk for developing autism. So it is not like you can go ask for an MRI right now for your baby to see if he or she will develop autism.
Yet this study is groundbreaking as it may be the first step in identifying biomarkers for children at risk for developing autism. In the future it may mean that that we will be able to diagnose children far earlier and begin intervention in infancy.
It also means that perhaps we parents who have a child with autism can lose the guilt over wondering if we did anything “wrong” during our child’s development to cause this disorder. It wasn’t so long ago that the psychological world believed the irrational rants of Bruno Bettleheim who proposed that “refrigerator mothers” caused their child’s autism. In more recent years the public was subjected to bad science when vaccines were blamed for the rise in autism diagnoses. As these unfounded theories have been disproven, this new study and others are pointing more to genetic factors and early deviations in brain development as the cause for autism.
What are the traditional ways to identify autism in babies and toddlers?
Although this brain imaging study is remarkable we still need to rely upon traditional methods of detecting the early warning signs of autism. This includes observation and behavioral check lists.
For those interested in a personal firsthand account of the signs and symptoms of autism from a parent’s perspective please read my post, “Detecting the Early Warning Signs of Autism.”
Autism Speaks, an advocacy organization devoted to the prevention and treatment of autism, outline some of the possible warning signs of autism in infants and toddlers:
• At six months there is a lack of smiling or other expressions of joy.
• At nine months there is no reciprocal sharing of smiles, facial expressions, or sounds.
• At 12 months your child is not babbling, pointing, waving, reaching, or showing you things of interest in his or her environment. There is no verbal or non-verbal give and take.
• At 16 months your child is not saying single words.
• At 24 months your child is not spontaneously putting words together to form two-word phrases in order to communicate.
• Regression of any sort, but especially in the loss of speech, can be an early sign of autism.
With our son Max, there was no lack of cuddling, smiles, and laughter. But there was a definite lack of pointing or responding to our pointing. He did babble but did not form words. Max had only about three words to his vocabulary by the age of two but he could recite the entire alphabet. He never asked “What’s that?” or any question. He engaged in imaginative play but did not share his play with us.
The point I wish to make is that no check-list is definitive of what is and is not autism. Every child is different in how they will exhibit autism symptoms early on.
If you suspect that your child is at risk for developing autism (she or he has an older sibling who has been diagnosed with an autism spectrum disorder) or is showing early signs or symptoms of autism please do not hesitate to ask your pediatrician for guidance. The sooner autism is identified, the earlier you can begin intervention and treatment.
We would love to hear from you. If you have a child on the autism spectrum can you tell us if you saw any early signs of this disorder in your child during infancy? Your story could help another parent who is looking for firsthand accounts of what autism can look like in the earliest years.
Published On: February 29, 2012