Guest post by Kasia Chawarska, PhD, associate professor of child psychiatry and pediatrics at the Yale University School of Medicine. Dr. Chawarska’s research team is part of Autism Speaks Baby Siblings Research Consortium.
Last week, our research team published a study suggesting that subtle signs present as early as six months of age foreshadow the onset of autism spectrum disorder (ASD).
For several years, we’ve been following more than a hundred infants from ages 3 to 36 months. Fifty were from families unaffected by autism. Sixty-seven were at elevated risk because they had an older sibling on the autism spectrum. Knowing that older children with ASD have difficulty paying attention to people and their activities, we looked for similar problems in infants who later develop autism.
To do so, we used an eye-tracking method that allowed us to monitor where the infants were looking when they watched a video depicting a friendly woman doing simple everyday activities. (See photo.) In the video, the woman made a sandwich, tried to direct the babies’ attention to toy animals and looked toward the infant, as if trying to make eye contact. She would smile and say, "you are so cute!” and “did you see the tigers?”
We wondered whether six-month-old infants who later developed ASD would follow the same elements of the video as did those who did not go on to develop the disorder. Those who did develop autism tended to have more difficulties attending to the woman’s face and her activities.
These findings suggest that even at six months, babies who later develop ASD use somewhat different rules to select what they find important in their environment. This is important because, in essence, all babies choose what they learn about by selecting what they look at. As a result, even subtle differences in early social attention may influence the later development of interaction and communication skills.
In our follow-up research, we’re now searching for the underlying reasons for these attention difficulties. We hope this will help us identify new treatment targets and early intervention strategies.
At this point, we’re not ready to push the age of autism diagnosis into the first year of life. And even if confirmed, the findings in in our study required the use of sophisticated equipment and analytical software. These aren’t yet available outside a research setting.
However, our new finding suggests an important direction for further research. Knowing that observable signs and symptoms can emerge as early as 6 months is the foundation for developing tools that will enable parents and clinicians to identify infants affected by autism. We likewise hope to find ways to intervene and help these at-risk infants.
Meanwhile, if you notice your baby showing limited attention to you and others, should you talk about it with your healthcare provider? The answer is an emphatic “Yes!”
If you notice that your child is not paying attention to your face or does not respond to your smiles and gentle voice, bring this to the attention of an expert. These behaviors do not mean your child has autism. However, they suggest that your child’s development might need to be monitored more closely.
The Yale team’s recently published study was supported by the National Institute of Mental Health and National Institute of Child Health and Development. Co-investigators included Suzanne Macari, PhD and Frederick Shic, PhD.
Editor’s note: For more resources on early screening, diagnosis and treatment, please see Autism Speaks Early Access to Care initiative and this website’s Screen Your Child and Learn the Signs resource pages.