How Early Is Too Early to Diagnose Autism?

While signs of autism appear in the first year of a baby’s life, parents (and even parents who have an older child on the autism spectrum) do not seem to note these changes, according to a just-published study by Ozonoff et al., in the Journal of the American Academy of Child & Adolescent Psychiatry
50 infants—25 of whom were later diagnosed with an autism spectrum disorder and 25 of whom were later determined to be developing typically—were studied starting at the age of 6 months. Researchers rated the infants according to “frequencies of gaze to faces, social smiles, and directed vocalizations,” by viewing videos of the children. While both groups of children rated the same in these areas at 6 months, further evaluation of the children at 12, 18, 24, and 36 months of age revealed “significantly declining trajectories over time” in the children later diagnosed with autism. Indeed, by the age of 12 months discrepancies between the groups were significant.

As noted in an editorial accompanying the study by Tony Charman, an autism researcher at London’s Institute of Education, what’s especially of note is that parents—even parents who already had an autistic child—did not report a regression in their child’s development. The study, as Dr. Charman writes, “advance[s] and inform[s] our understanding of the complex heterogeneous neurodevelopmental conditions that we now consider ‘the autisms’”; just twn years ago “the pro- spective study of the emergence of early or even prodromal signs of autism would not have been considered possible or practicable.” The sooner that autism is diagnosed, the sooner parents can start seeking treatment—early intervention, usually in the form of behavioral, speech, occupational and educational therapies—for a young child. Some studies show that, for some children, such early treatment can result in a child making significant gains in their development, to the extent that done children do not qualify for special education services and may no longer be thought to have an autism diagnosis.

The subject of when autism is first detected in a child, is a potentially volatile one in discussions about the causes of autism. For those who believe that vaccines or something in vaccines “caused” their heretofore typically developing child to “regress into autism,” studies stating that signs of autism can be seen in their child prior to that child being vaccinated would refute, and indeed undermine, claims of “autistic regression.” The Ozonoff study also puts into question the assertion—made by Leo Kanner and others—Ozonoff et al. suggest that “regression might be the norm and not the exception in autism.”

As Melissa Healy writes in Booster Shots in the LA Times,

“The study calls into question the bases on which much early speculation about and research on autism and its causes have been based: parental observation. For starters, the study found little to support the observations of some parents that their baby showed symptoms of extreme social disengagement from birth. But it also cast doubt on the accuracy of parents’ reports that their baby’s descent into autism was sudden and dramatic.”

My husband and I did not think there was anything delayed about our son Charlie‘s first year development, as far as his social behavior. Charlie’s gross motor development was delayed (he was late to roll over, sit up, pull himself up, and walk); such is not the case for many children on the autism spectrum. In reading my notes in Charlie’s “baby’s first year” baby book, I detect a decidedly cheery tone. My older, hopefully a bit wiser self wonders if I was trying to mask a sense of unease. It’s been mostly from observing other babies and children that I’ve realized how much Charlie, a baby who loved to be carried and smiled so much, was developng diffrently and, in some areas, much more slowly and even not at all than other children. As a baby, for instance, Charlie did not show signs of joint attention, of trying to share his interest in things with others. He was a notably “good” child, who never tried to empty cabinets of pots and pans, and preferred sitting on his quilt and going through the toys in front of him. 

And even if “autism” had been suggested to us about less-than-a-year-old Charlie, I’m not sure we would not have scoffed and said “oh, it’s too early  to tell.” If parents and the public can understand that am autism diagnosis is not some sort of judgment or critique, but just what it is, a diagnosis, a label, a means to start addressing their child’s particular needs, perhaps there could be more acceptance of, and less wariness about, an early diagnosis. An autism diagnosis is not a death sentence, and if we lessen the fear associated with diagnosis, hearing that one’s young child us on the spectrum might seem rather a beginning—not what one expected, but definitely not an end.    

Photo by eyeliam.
Kristina Chew, Ph.D., Assoc. Professor of Classics at Saint Peter's College in New Jersey. Since 2005, she has been blogging about autism, disabilities, and education, previously at Autism Vox and now at We Go With Him, a daily journal about life with her 12 1/2 year old son. She has recently published essays in Disability Studies Quarterly and in Gravity Pulls You In: Perspectives on Parenting Children on the Autism Spectrum (ed. Kyra Anderson and Vicki Forman).

58 comments

jane richmond
jane richmond8 years ago

It's never to soon to ask questions if something doesn't seem right. Moms and dads should use their instincts. Doctors don't test for everything and don't know everything. Call things to their attention. If they poo-poo you stick to your guns and get a second opinion.

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sandra d.
sandra d9 years ago

http://articles.mercola.com/sites/articles/archive/2010/03/20/david-ayoub-interview-february-2010.aspx




It isn't just Thimerasol that is a concern. Check out the other dangers in this article.

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Joyce M.
Sandra D9 years ago

I wouldn't call it good. I would call it sad.

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Nellie K A.
Nellie K Adaba9 years ago

good article

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Elaine Dixon
Elaine Dixon9 years ago

guess i would want to find out as soon as the soonest possible time so I would be able to start looking for ways for him/her to live the best life possible

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sandra d.
sandra d9 years ago

I can only wish you good luck in your search, Penelope. I am afraid that alternatives are your only answer, since you will not find much within the establishment but poisonous drugs and more barbaric treatments.

I worked with autistic and other developmentally disabled children at a special school we used to have here in our district (that is until ONE parent had to ruin it for everyone by going to court so that her child could be "included" in a regular classroom). I think this has been a disaster and these children suffer because of it.

This school was wonderful and no child there felt "different" nor was anyone made fun of or singled out. Now, with inclusion, that sadly is no longer the case.

I wish you only the best in your search and hope that your grandchild will find the help he needs.

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Penelope H.

Continuing on with my Grandson 8 with aspergers. My daughter found a doctor who uses a treatment plan called NAET. It is an energy treatment plan used primarily to cure allergies of which autistic children have many. He had the wheat allergy so common to autistic children. The NAET plan has eliminated this allergy along with many other food allergies he had. He no longer wets the bed at night and is able to eat a wide range of foods he wouldn't touch before. He is extremely smart, but gets very obsessive about what ever it is he is interested in at the time. He has a very long way to go and I worry about his ability to get along in this world. Our society is highly competitive and has no patience for behavioral issues like my Grandson has. It is hard enough in this world to be able to raise a normal child let alone one who is confrontational about everything. The person who said that it is not disappointing to have a child with aspergers has no clue what that road is like.

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Penelope H.

I tried doing this yesterday but I do not see my comments here. I hope this works this time. My Grandson now 8 has aspergers. I have often felt totally frustrated in dealing with him and wished he was normal. It is very challenging to say the least to deal with a child like this. It has caused a lot of strife within the family. My daughter and her husband almost divorced over it. At any rate I know my Grandson had this before birth. A sona gram in utero showed holes in his brain. My children were preparing to have a Down's syndrome child. But when he was born they pronounced him normal. He had behavioral problems from the beginning. Not making eye contact is pretty classic. He never eat vegetables. When he was a baby he would cry if you tried to feed it to him. As he grew up his diet options were very limited. Mac n cheese or quesadillas with cheese were about all he would eat. He is extremely uncooperative. Group activities are out of the question. He is independent and frequently refuses to do anything asked of him including riding his car to close to an outside fire. He has many problems in school and for the longest time these behavioral problems were denied by my daughter. She did finally acknowledge his autism and the food allergies that go along with it. Some help has been forth coming through an alternative medical treatment plan called NAET. I am surprised no one on care2 seems to know about it. His weekly treatments are not covered by insurance and the Doctor says h

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Erin R.
Erin R9 years ago

good post

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sandra d.
sandra d9 years ago

Oh yes, and one more thing, since the medical establishment has created all these new diseases and of course, they do not want people to know THEY caused it, they are now blaming everything on genes or inherited conditions. What a joke!

I was having a discussion with someone the other day who has no idea what alternative medicine even is, who had the nerve to tell me that I was so healthy because "I must have good genes". This is the latest "bull" from the medical establishment.

But thankfully others are coming out and finally saying that even though you may have a gene for a particular something, how you take care of yourself determines HOW the gene will present, e.,g. if your entire family is fat, you may say, "Oh it's in our genes", but that's not really true. It is more about "learned behavior" and what you are modeled which determines that the "fat gene" will present that way--because you are eating the same way as your "FAT" family.

This "gene" excuse is a ruse--don't buy into it.

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