Early and Frequent Assessments May Improve Autism Diagnoses and Outcomes

Autism spectrum disorder (ASD) includes a range of mental health issues including Asperger’s syndrome, autism, and developmental problems not otherwise specified. All of these spectrum issues are evidenced by lack of communication and social skills at an early age. Some children also exhibit repetitive behaviors or decreased cognitive and motor skills. Regression of various capacities is not uncommon in children diagnosed with ASD and is often used as a marker by which parents can identify early signs of the illness. Most children with ASD are first diagnosed in their toddler years. But researchers are beginning to wonder if even earlier diagnoses are possible. If so, children could be placed in programs that address their communication and social needs at an earlier age. This could prevent the regression of skills in some children. Although there is an abundance of research on children with ASD, few of the studies conducted have focused on the trajectories of impairments in children diagnosed with ASD.

To address this gap, Catherine Lord at the Center for Autism and the Developing Brain and Department of Psychiatry at Weill Cornell Medical College at the New York Presbyterian Hospital recently led a study that evaluated 65 children, all approximately 18 months old. The children were all referred by parents concerned with signs of ASD. Lord also assessed 13 children who were part of other ongoing research programs. All of the children were clinically evaluated every other month for a year and a half by the same examiner. Every 6 months, a blind analysis was conducted.

The results revealed that many predictors of ASD, such as social deficits and repetitive actions, were evident as early as 18 months. The findings also demonstrated the importance of parent reports. The children who had been referred for concerns of ASD because they had a sibling with the disorder were much more likely to receive a positive diagnosis than those who had not been referred as a result of parental concern. Additionally, Lord also found that one-third of the children who had received a diagnosis of ASD at one point during their evaluation actually showed improvement in verbal, cognitive, and behavioral skills over the course of the study. She said, “This pattern highlights the need for continued assessment and monitoring, not only for children who do not progress but also for children who show marked improvements.” Lord believes that these findings emphasize the need for more frequent monitoring and assessment of children at risk for ASD.

Lord, C., Luyster, R., Guthrie, W., Pickles, A. (2012). Patterns of developmental trajectories in toddlers with autism spectrum disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0027214

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  • Margaret


    April 27th, 2012 at 2:59 PM

    I know that parents who have an autistic child already are going to be more aware of the markers to look for in a second or third child exhibiting the same types of symptoms that they may have previously witnessed in the other child.
    What might have seemed normal to them the first time around gives them the perspective of being on the lookout for behavior that they may view with a little more awareness if it shows up again.

  • dede


    April 27th, 2012 at 3:59 PM

    I am surprised to read that much of the behavior that is seen in autistic children is evident as early as 18 months of age. I don’t know that much about autism but I always thought that it showed up a little later, like maybe around the age of 3. But I guess that earlier someone notices the symptoms then the better chance there is to get an accurate diagnosis and the best treatment possible. I would ahte for all of that precious early time to be lost as I am sure the parents of these kids feel the same.

  • jamie


    April 27th, 2012 at 9:48 PM

    autism seems to be taking off if u look at d stats.great to have techniques that can identify the same at a very early stage.hope v can stop this disorder from taking over our children.

  • tyler peace

    tyler peace

    April 28th, 2012 at 6:04 AM

    sure would hate it if due to your expectations with one child that you project onto your next the same thing
    all for early identification, but don’t jump to conclusions, could be nothing, but i guess if it is something you are already dealing with it is not a bad idea to get it checked out

  • Katie Wright

    Katie Wright

    April 28th, 2012 at 10:59 AM

    It would be so great if more of our research money was given to clinician MD researchers, rather than psychologists. Lord has been studying regression for almost 20yrs and her work has yet to lead to any insight on what is causing regression and how to stop it. We can measure regression a 1,000 different ways but we need to start listening to parents and actually study the environmental factors and dangerous exposures that preceded the regression.

    I resent the silly nitpicking about -oh the regression is not a real regression because the child exhibited gradual loss of speech from 18 months to 24 months. So what? Why aren’t you trying to figure out why? And is it a big insight that siblings are at risk? They are exposed to almost identical environmental triggers. We cannot change our genes and no amount of early intervention is stopping this epidemic. Let’s get serious about environmental research rather than just counting the damage done.

  • Katie Wright

    Katie Wright

    April 28th, 2012 at 11:02 AM

    Early behavioral intervention rarely halts regression. Regression is highly correlated with medical problems. ABA cannot fix GI disease. Let’s look at the whole child when dealing with regression and get out of the lab.



    April 28th, 2012 at 11:59 PM

    Identification of a possible future disorder sounds like a great start. And not only do we need to invest in such research but also in methods to identify and effectively stop the future disorder. Only then will this identification be fruitful.No use identifying the enemy unless you have the ammunition to eliminate them,yeah?

  • Programmed kid

    Programmed kid

    April 29th, 2012 at 2:47 AM

    With all these advancements of identifying diseases in infancy and much earlier,the day is not too far when we will have kids that are programmed to be free of any diseases and problems.will it be a reality or is it just science fiction?

  • melissa


    April 29th, 2012 at 4:31 AM

    I guess it is so hard to pinpoint specific environmental factors that could contribute when there are siblings who are exposed to the same exact things in the same kind of environment and yet they don’t end up with the disease. So for me that speaks to the fact that there must be something genetic going on for this to happen to one child and not another. But I am always so curious about what happens at this specific age that causes autism to rear its ugly head?

  • Wyatt


    May 1st, 2012 at 5:15 PM

    I think that as a parent you know when something does not seem quite right with your own child.

    Don’t let anyone tell you it’s just a phase or it will blow over.
    If you are concerned go see a doctor until you get an answer.

    Letting someone give you the runaround could be wasting precious time for a diagnosis.

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