According to Mathew T. Pletcher, vice president and head of genomic discovery at the advocacy group Autism Speaks, the new study made great use of modern technology as well as a recognized phenomenon of autism: Children with a sibling diagnosed with autism are at much greater risk of developing the disorder.
Autism spectrum disorders-so called because they present a wide range, or spectrum, of different social and communication challenges-are often characterized by behaviors that include rocking motions or obsessions. This is important, says co-author Heather Cody Hazlett, a psychologist at the Carolina Institute of Developmental Disabilities, because behavioral cues don't work very well for infants: Before the age of two, children who go on to develop autism behave nearly identically to those who do not.
Over the last 12 years, more than 100 children were scanned at 6, 12 and 24 months old.
If it's possible to detect changes in brain development as early as 6 months to 12 months of age, you could conceivably begin working with an infant very early on and "try to help nurture their development in a way that's going to be most beneficial".
Piven said the research can be likened to similar efforts to detect other brain disorders earlier in life, such as Parkinson's or Alzheimer's, before they begin to impair patients.
"These findings suggest a cascade of brain changes across the first two years of life that result in the emergence of autism at the end of the second year", explained study senior author Dr. Joseph Piven. But for infants with an autistic older sibling, the risk may be as high as one out of every five births.
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He is director of the Carolina Institute for Developmental Disabilities at the University of North Carolina, Chapel Hill.
"We now have this finding in these high familial risk infants that we can predict 8 out of 10 that we think will get autism", says Piven, adding that behaviour-based predictions do no better than 50-50 at that age. At that point, the overall brain volume increases faster in children with autism than in controls. The unusual growth preceded a rise in brain volume over the following year that was linked to social difficulties the children developed.
As an NIH-funded Autism Center of Excellence, the researchers' data and tools are open-source and will eventually be submitted to the NIH's National Database for Autism Research. When combined with brain volume and sex of the infants, it predicted most of the ASD cases among the group.
There is no evidence that the risk of developing autism can be reduced in infants, says Raznahan, and the immediate application of early diagnosis would be to inform families. "Using brain imaging, we were able to pinpoint areas of the brain where atypical development contributes to autism".
'Putting this into the larger context of neuroscience research and treatment, there is now a big push within the field of neurodegenerative diseases to be able to detect the biomarkers of these conditions before patients are diagnosed, at a time when preventive efforts are possible, ' Piven said. "In Parkinson's, for instance, we know that once a person is diagnosed, they've already lost a substantial portion of the dopamine receptors in their brain, making treatment less effective".
"There's a developmental sequence", he said, "and it raises the possibility that we could sort of disrupt that sequence early on". "The fact that they're not consistent suggests that some of the expansion in surface area may actually not be relevant to the detection of autism", he says. Other key collaborators are McGill University, the University of Alberta, the College of Charleston, and New York University. That change happened before the child's first birthday. In addition, its unique family-centered care and public service programs have brought the 535-bed hospital recognition as a leading advocate for children and adolescents.