Early Warning System: Autism and At-Risk Children

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AUTISM SPECTRUM DISORDERS (ASD) are being diagnosed at an all-time high in the United States, with an estimated one out of 150 children, mostly males, being identified with a neurodevelopmental problem by the time they’re 3 years old. And although it was first identified as a specific disorder back in 1943, the nature of autism has continued to baffle and divide the scientific community. One of the few areas in which the experts agree is the importance of early identification and intervention, followed by developmental behavioral treatment by experts in the field of ASD.

“Pediatricians are in a key position to be the first to identify infants at risk for autism,” says Eric Courchesne, professor of neuroscience at the University of California, San Diego, director of the Center for Autism Research at Rady Children’s Hospital Research Center, and a leading researcher in the study of the neural basis of autism.

UCSD and Rady Children’s Hospital are leading the way in autism research and services, with world-class experts on hand to evaluate and treat cases of ASD. Courchesne, along with Dr. Karen Pierce from the Center for Autism Research at Children’s Hospital and UCSD’s Department of Neurosciences, has gathered a large team of San Diego pediatricians who are currently working to develop a screening tool for early ASD identification.

“The major breakthrough that makes studies of autism possible at 12 months comes from Pierce, who came up with an incredible plan to work with pediatricians to make early identification possible,” says Courchesne. “Before this, children were often not referred for possible autism until 2, 3 or even 4 years of age. Dr. Pierce’s method gets infants at risk for autism referred at a far younger age to experts who can then make the determination if further attention and help is needed; this is far earlier than the common practice.”

For parents with that inescapable, gut-wrenching feeling that something could be wrong with their child, the juxtaposition between normal behavior and what may be the proverbial red flag can be precarious. A child may not recognize his or her name or light up when a parent enters the room. Or maybe the child isn’t making eye contact. By acting on those sneaking suspicions right away and mentioning them to the family pediatrician instead of hoping the problem will go away, parents could be making a crucial move toward a diagnosis. (See sidebar for a list of early warning signs.)

One important but simple, noninvasive early identification test that could potentially yield rich results involves measuring the infant’s head circumference over time. An increasingly large head circumference between one and two months and then six to 14 months, preceded by a normal or even slightly reduced head size at birth, may be an early warning sign before any clinical behavioral signs, however subtle, are exhibited.

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