Diagnosing autism in the youngest of patients

More than 1 in 100 individuals are diagnosed with Autism Spectrum Disorder (ASD), with profound impacts on the quality of life of those who are affected and their families. Many parents of children with ASD identify concerns as early at 12-18 months of age, yet the average age of diagnosis remains around four years. Children who receive an early diagnosis of ASD can benefit from a growing array of evidence-based interventions. There is also evidence that diagnosing and treating autism earlier leads to better long-term outcomes for children and families, and reduces ultimate societal costs related to treatment.

Over the past decade, studies of highrisk infants – younger siblings of children with ASD – have revolutionized the field, bringing us to the threshold of earlier diagnosis and treatment. The members of this international team are made up of researchers from Canada, UK and Israel who have been at the forefront of research on this high-risk cohort of “baby sibs” and for this particular project they are expanding on previous research on the early development of ASD.

They are looking at how at-risk infants direct their attention and regulate their emotions, and how this relates to their ability to communicate and interact with others. They believe these relationships may help in understanding the earliest expression of ASD. Their research project consists of two related projects.
In the first project (involving the Canadian and Israeli teams) they will examine how flexibly infants shift their attention from one interesting object to another, and how this influences their responses to situations that elicit positive or negative emotion. Infants who have difficulty shifting their visual attention may also get ‘stuck’ on intense emotions, and that may impair both their ability to interact and communicate with others, leading to increased risk of ASD. In the second project, they will test whether teaching infants to become more flexible in shifting their attention (using computer games developed by their UK team) helps them benefit further from other interventions developed by the Canadian and UK teams. The team has just completed the first year of their grant.

Progress has mainly focused on preparing the research team trialing new technologies for the home-based intervention trial, working with international partners to learn the novel intervention approaches that they believe will further optimize benefits to infants with early signs of ASD, and engaging with community partners to begin the process of ensuring that findings from their research will ultimately be incorporated into clinical practice.

They have also begun data collection activities for their early detection study, as well as the intervention trial. The next steps involve accelerating recruitment into both studies to achieve their ultimate goal of mapping early developmental pathways of ASD risk and understanding how these pathways can be targeted to improve on interventions for children with early signs of ASD. Based on findings from this research, they will train health professionals to better identify the earliest signs of ASD, and work with community partners to implement new interventions to help these children reach their potential.

“ Collaboration with our international partners has been essential to the innovative aspects of this research program. ”

— Lonnie Zwaigenbaum, M.D University of Alberta