It’s estimated that 1 in 68 children in the United States are born with autism, a number that has more than doubled since 2000, making it the fastest growing developmental disability in the U.S. It is suspected that part of the reason for the increase is due to the increased awareness about autism, and children are being diagnosed earlier. The sooner a child is diagnosed in life, the better chance there is for them to learn to manage their symptoms and live a more productive and independent life.
Today, the Center for Disease Control reports that the average age for an autism diagnosis is age 4, but in 2011 that was focused on children between 6 and 17 years old who had been diagnosed with autism spectrum disorder, half were diagnosed after age 5. Now, many children are being screened for autism at 18 months old, as recommended by the American Academy of Pediatrics, but it may be possible diagnosis and treatment can start even earlier.
Early detection options for diagnosing autism
Traditionally, children have been diagnosed with autism after undergoing an analysis of their behavior and the rate they are achieving various developmental milestones. There are several milestones that parents should be aware of, even with infants and keep their child’s pediatrician informed of any concerns they might have.
Knowing key child development milestones
By three months, children should be grasping objects, responding to loud noises, moving objects, and new faces. They should also be babbling and smiling at people. By the time they are 7 months they should turn their head to identify where a sound is coming from, reach for objects, seek attention, laugh, play games such as “peek-a-boo” and be affectionate towards people she knows well. At one year a child should crawl, say singular words, and gestures like shaking the head or waving, point, and stand with support. By age 2 children should be walking, be able to say more than 15 words, use 2 word sentences, imitate caretakers, push wheeled toys, and know how to follow directions.
Evaluating usual behavior in babies
Missing an occasional milestone doesn’t always mean a child is autistic or has another developmental disorder or disability such as ADHD or mental retardation, but it is a sign that psychological evaluation may be in order. One 13 month old child received an evaluation from a psychologist at the University of North Carolina- Chapel Hill and it was noticed that the child would pick up objects and swing them nearly constantly. The psychologist noticed other behaviors too, such as the boy shaking a board book near his ear. These unconventional behaviors, combined with the lack of typical behaviors brought about a concern that the boy had a high likelihood of developing autism.
A decade ago, diagnosing the risk of autism in a child under 2 was very rare. Some children are evaluated as young as six months, but making a firm diagnosis of being on the autistic spectrum in rare. Instead they are identified as children “at risk” and are watched for other signs to emerge as well.
Undergoing behavior analysis has helped many children who have been diagnosed with ASD by getting them started on a treatment plan. But many families are unable to access ABA without a diagnosis.
In order to provide more children with an early diagnosis, new methods are being investigated and tested. One of these methods is a saliva test to confirm a diagnosis. Recent research findings were published in the online journal Autism Research. Researchers involved both boys with ASD and those without ASD in their study that looked at protein levels in the children’s saliva. Nine different proteins were discovered to be elevated in children with ASD, while an additional three proteins were not present at all in the boys with autism.
The “protein signature” was similar to what is experience by people with gastrointestinal problems, which can be more common for children with ASD, but are harder to identify because of the child’s communication challenges.
Saliva tests are encouraging, because they can potentially be used along with behavioral analysis to diagnose autism at a younger age. However, there is still work to do. One limit of the study is that only boys were involved. While autism is more prevalent in boys, there are also plenty of girls on the autistic spectrum that could potentially have a different “protein signature” than the boys. Still, the research has encouraging implications including the possibility of earlier and more definitive diagnosis than current methods.