Developmental tests could detect autism at an even younger age

(HealthDay) – The earlier an autistic child is diagnosed, the better, and new research now describes a new way to catch it sooner than ever before.

The study suggests that well-attended child visits involving developmental screening might provide early indications of a risk of autism in some children.

"We think this could identify children at risk of autism at an even younger age," said lead researcher Whitney Guthrie. She is co-director of the data and statistics core of the Center for Autism Research at the Children's Hospital of Philadelphia. "If we detect more frequently between 9 and 18 months, we may be able to identify this pattern of risk even earlier."

In the study, young children whose normal development began to slip behind that of other children – a process called deceleration of development – seemed more likely to be diagnosed later with autism. .

About 20% of children with a declining developmental trajectory were diagnosed with autism, compared with only 2% of all children, the researchers found.

Previous studies have shown that decelerating development may be one of the first behavioral characteristics in children at risk of autism and may even precede the onset of clear symptoms of autism, explained Guthrie.

However, these studies have all been conducted in children already at high risk of autism, due to genetic or other factors, she said.

To determine if this trend would continue in all children, Guthrie and her colleagues studied nearly 32,300 children screened for development in one of the 31 primary health care centers of the hospital for Philadelphia children.

Developmental screenings should take place at the age of 9 months, 18 months and 24 or 30 months, according to the guidelines of the American Academy of Pediatrics.

The researchers followed the results of these screenings and found that infants and toddlers typically enroll in one of six different developmental trajectories.

Nine out of ten young children follow one of four trajectories reflecting the steady progress of their development over time, said Guthrie.

But investigators found that 10% of children have a declining trajectory.

"They were kids who had maybe strong developmental skills at nine months, but their skills were not keeping pace with other kids their age," Guthrie said. "These scores diminish over time and these kids are falling further behind other kids their age."

The research team compared children's developmental trajectory to autism screenings done at age 10 or older, to see if a developmental delay would indicate a future risk for children. # 39; autism.

"It seems that this paradigm shift in non-autistic skills – things like communication and motor milestones – clearly confers a risk of autism," Guthrie said.

Tracking children's developmental trajectories also seems to more accurately predict the risk of autism than conventional screening tools, the study authors said.

Deceleration in development detected 65% of children diagnosed with autism, compared with 50% for standard autism screening, the researchers reported.

The good news, used jointly, both methods have detected 75% of future autism cases, "which represents a marked improvement over the status quo in autism screening," said Guthrie.

These results show that doctors could exploit the data they already collect to better detect children at risk of autism, she added.

However, further studies are needed before the developmental trajectory can be established as a sure way to predict autism, noted Guthrie.

"If you find that developmental skills diminish over time in children who have previously reached developmental milestones, it is certain that their evaluation and consideration are justified and that autism should be part of the conversation," he said. Guthrie.

The results were presented Wednesday at the annual meeting of the International Society for Research on Autism (INSAR) in Montreal. Such research is considered preliminary until it is published in a peer-reviewed journal.

INSAR President, Dr. Simon Baron-Cohen, said that research on these developmental pathways, combined with genetic data and brain tests, could provide new information on autism and information. Other developmental disorders.

"At some point, it will be important not only to monitor these children who show this type of slowdown, but also to intervene," Baron-Cohen said. "If you find that children are falling further behind and that the gap is widening between their development and the typical children, we have the obligation to start also to try some interventions and see if you can change course. "

More information:
Whitney Guthrie, Ph.D., co-director, core data and statistics, Center for Autism Research, Philadelphia Children's Hospital; Simon Baron-Cohen, M.D., President of the International Society for Research on Autism (INSAR); May 1, 2019, presentation, annual meeting INSAR, Montreal

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