Autism spectrum disorders in the first 3 years of life

Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, MD 21211, USA.
Nature Clinical Practice Neurology (Impact Factor: 7.64). 04/2008; 4(3):138-47. DOI: 10.1038/ncpneuro0731
Source: PubMed


Autism spectrum disorders (ASDs) are a class of neurodevelopmental disorders defined by qualitative impairments in social functioning and communication, often accompanied by repetitive and stereotyped patterns of behavior and interests. The term 'ASD' encompasses autism, pervasive developmental disorder not otherwise specified, and Asperger's syndrome. ASDs show etiologic heterogeneity, and there is no definitive medical test or cure for these conditions. Around 1 in 150 children have an ASD, with males being affected three to four times more frequently than females. The age at diagnosis of ASD ranges from 3 to 6 years, but there is increasing evidence that diagnosis in the second year of life is possible in some children. Early diagnosis will lead to earlier behavior-based intervention, which is associated with improvements in core areas, such as social functioning and communication. Early detection of-and intervention to treat-ASD is crucial because it is likely to lead to an improved outcome.

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    • "In typically developing children, attachment is usually formed within the first 2 years of life (Ainsworth and Bell, 1970), the same critical period during which the earliest signs of an ASD are present. In fact, some of the earliest presented symptoms indicative of an ASD, such as impaired social responsiveness, decreased social approach, decreased shared enjoyment and social smiling, and difficulty regulating affect (Landa, 2008; Zwaigenbaum et al., 2009), are all behaviors deemed essential for judging the quality of an attachment relationship. Therefore, the nature of some of the earliest signs of ASD, regardless of parental sensitivity, may discourage the attachment relationship between the parent and the child. "
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    ABSTRACT: Most studies examining attachment in children with autism spectrum disorder used a strange situation paradigm and have found few significant group differences between children with autism spectrum disorder and comparisons. However, these studies predominantly used formal attachment categorizations (e.g. secure vs insecure), a method that may obscure more nuanced differences between groups. In this study, we utilized a qualitative approach to examine attachment behaviors in young children with autism spectrum disorder. Based on the results of previous studies, we looked at (a) parental gender, (b) child diagnosis, and (c) child cognitive skills to examine the role of these three factors on attachment behaviors elicited during a modified strange situation paradigm. Participants were 2- to 3-year-old children with autism spectrum disorder (n = 166) or nonspectrum disorders (n = 45), as well as a sample of 56 children with typical development. Over the three groups, 393 observations of a modified strange situation paradigm with mothers and 127 observations with fathers were collected. Parental gender, child diagnosis, and child cognitive skills each had significant main effects on attachment behaviors elicited during reunion. These results underscore the importance of the father's role in parent-child interactions, with implications for both clinical and research efforts. In addition, the results emphasize the importance of considering a child's diagnosis and cognitive skills when examining attachment behaviors.
    Full-text · Article · Dec 2012 · Autism
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    • "Understanding how genetic and environmental risk factors in autism converge at synapses might provide a valuable starting point for future work towards uncovering the patho-mechanisms of autism. Autism is a developmental disorder and most cases are diagnosed by the age of three and as early as 14 months (Landa, 2008). Nonetheless, autism might be present from birth on rather than develop within this developmental time window. "
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    ABSTRACT: Autism is a neurodevelopmental disorders characterized by impairments in communication and social behavior, and by repetitive behaviors. Although genetic factors might be largely responsible for the occurrence of autism they cannot fully account for all cases and it is likely that in addition to a certain combination of autism-related genes, specific environmental factors might act as risk factors triggering the development of autism. Thus, the role of environmental factors in autism is an important area of research and recent data will be discussed in this review. Interestingly, the results show that many environmental risk factors are interrelated and their identification and comparison might unveil a common scheme of alterations on a contextual as well as molecular level. For example, both, disruption in the immune system and in zinc homeostasis may affect synaptic transmission in autism. Thus, here, a model is proposed that interconnects the most important and scientifically recognized environmental factors. Moreover, similarities in how these risk factors impact synapse function are discussed and a possible influence on an already well described genetic pathway leading to the development of autism via zinc homeostasis is proposed.
    Full-text · Article · Nov 2012 · Frontiers in Psychiatry
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    • "We also recommend that motor delays be addressed through motor interventions to enhance motor development and movement-based social skills such as imitation and communicative gestures. Specifically, early low-cost, caregiver-provided enhanced object-based and postural experiences could significantly improve the motor functioning of infants at risk for ASDs (Landa, 2008; Lobo & Galloway, 2008; Lobo, Savelsbergh, & Galloway, 2004). Thus, motor experts such as occupational and physical therapists should be included as members of the early intervention team assessing infants and children at risk for ASDs. "
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    ABSTRACT: BACKGROUND: Motor delays have been reported in retrospective studies of young infants who later develop Autism Spectrum Disorders (ASDs). OBJECTIVE: In this study, we prospectively compared the gross motor development of a cohort at risk for ASDs; infant siblings of children with ASDs (AU sibs) to low risk typically developing (LR) infants. METHODS: 24 AU sibs and 24 LR infants were observed at 3 and 6 months using a standardized motor measure, the Alberta Infant Motor Scale (AIMS). In addition, as part of a larger study, the AU sibs also received a follow-up assessment to determine motor and communication performance at 18 months using the Mullen Scales of Early Learning. RESULTS: Significantly more AU sibs showed motor delays at 3 and 6 months than LR infants. The majority of the AU sibs showed both early motor delays and later communication delays. LIMITATIONS: Small sample size and limited follow-up. CONCLUSIONS: Early motor delays are more common in AU sibs than LR infants. Communication delays later emerged in 67-73% of the AU sibs who had presented with early motor delays. Overall, early motor delays may be predictive of future communication delays in children at risk for autism.
    Full-text · Article · Sep 2012 · Infant behavior & development
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