Perspective on Breakthrough Report on Autism and Infant Eye Gaze

Friday, November 8, 2013 View Comments

Our families have expressed great interest in a study published this week showing declining eye contact in infants who go on to develop autism. We’ve asked Paul Wang, Autism Speaks vice president for medical research, to discuss the larger implications around this study and related research. Dr. Wang is a developmental-behavioral pediatrician with extensive experience researching treatments for autism.

Because autism is difficult to diagnose reliably before 3 years of age, researchers have been trying to better understand its earliest signs and symptoms. This is so important because the earlier we intervene with autism, the greater our chances of achieving optimal outcomes.

For good reason, much of the research on early symptoms involves the younger siblings of children who have autism spectrum disorder, or ASD. These “baby sibs” have a greatly increased risk of developing autism. This week’s breakthrough study by Warren Jones and Ami Klin is part of this line of research. Dr. Klin is a principal investigator in Autism Speaks Baby Siblings Research Consortium.

Drs. Jones and Klin found measurable differences in eye-gaze patterns between 2 and 6 months of age in babies who went on to be diagnosed with autism. These babies actually started out with normal eye-gaze patterns. But month by month, they showed steady decreases in the amount of time they looked at a caregiver’s eyes. Such eye-to-eye contact is crucial to social and communication development.Baby sibs who did not develop ASD did not show this pattern.

Because this was a small pilot study, confirmation is needed in a larger group of infants. Ideally, the results should be confirmed by an independent research team. (Science is an inherently skeptical process.) The results are consistent, however, with previous research that shows differences in behavior and brain function beginning to emerge later in the first year of life.

The new results also reflect the importance of genetic factors in ASD. Some people have been skeptical of the role of genetics in ASD because some affected children appear to develop typically at first, but then show a regression in language and social skills, often becoming apparent shortly before their 2nd birthday. The new eye-gaze findings suggest that subtle symptoms can be found at a much younger age, and that these very early symptoms continue to worsen over time.

The differences in eye gaze that Drs. Jones and Klin describe required painstaking experimental methods to detect. So it’s important to emphasize that parents shouldn’t scrutinize their baby’s every look or action. What’s more, we don’t know yet whether these differences in eye gaze can be used to diagnose autism. The study was far too small to make such a conclusion. Rather, researchers must take the new findings as a call to arms. Are there interventions that may be helpful in the earliest months of life?  If we start treatment in that early time window, can we minimize – or even avoid – the problems that might otherwise arise?

These are important questions and tremendous opportunities to explore – with the potential for reaping benefits in the years ahead.

I want to thank Autism Speaks’ passionate community of families and other supporters for making so much of this progress possible.

Read more about Autism Speaks Baby Siblings Research Consortium, its discoveries and their importance to families here.