The Full Spectrum: Is Five Minutes All It Takes To Detect Autism In Babies?

The Full Spectrum focuses on the trials and tribulations of raising a child who ranks on the autism spectrum.

The Journal of Pediatrics reports this month that neuroscientists at the University of California San Diego have created a five-minute screening test that could detect autism in babies as early as 12 months old. This is big news. Until now, specialists working in the autism field believed there is no accurate way to diagnosis children until they’re at least 3 years old and, for some autism spectrum disorders like Aspergers, as old as 6 or 7.

The new, five-minute screening test is called ”The One-Year Well-Baby Check-Up Approach” that, if implemented nationally, will allow pediatricians to detect cases of autism in babies during their one-year checkup. It’s simple, really: parents fill out a checklist that asks questions about eye contact, sounds, words, gestures, object recognition and other kinds of age-appropriate communication benchmarks (for example: “When you call your child’s name, does he/she respond by looking or coming toward you?”).

While researching the effectiveness of this screening, scientists followed up every six months with families whose children ”failed” the checklist test. They found that the original screening was 75 percent accurate at predicting autism (can you imagine the 25 percent false positives?).

As the mother of an 8-year-old with Aspergers, the news of this early-age screening transported me right back to my life pre-diagnosis. After S. was born, I had 6.5 years of blissful ignorance with our sweet and smart child who just happened to be immature. At least that’s what I thought I was dealing with when it came to my son’s quirks and lack of impulse control. We convinced ourselves that with maturity, he would stop pouncing on his playmates when he got excited, or begin to understand that people were bored with a 20-minute rant about Pokemon (or whatever his obsession du jour). Immaturity seemed like the only reasonable explanation at the time.

It wasn’t like S. was a stereotypical vision of an autistic child spinning in circles without verbal skills. My son had friends, started speaking early (at nine months), walked on schedule, loved to run around and play make-believe, and could be dropped of anywhere with anyone without a fuss. Autism never even crossed my mind. Could my pediatrician really have asked me a set of questions when S. was 12 months old and diagnosed him with an ASD? Would I have listened?

One problem with diagnosing a 1-year-old is that you are relying entirely on the observations of the parents. These are people who generally want to see the best in their child but also hold a microscope to every behavior out of fear and competitive instincts. When you go through the diagnosis process at 6 or 7, the psychologist talks and ask questions to the parents and also spends extensive time with the child, testing him for things like IQ, working memory, fine and gross motor skills and more. Teachers are included in the assessment to help make the picture more complete. (Interestingly, teachers are often cited as the major influence in a positive ASD diagnosis.) Although this diagnosis process is less than perfect in many ways (for starters, there are many different diagnostic screening tests and differing philosophies in the ASD professional community, which can make the whole process seem like some form of random chaos it is a lot more fulsome than a five-minute screening program.

During the early years of my son’s life, people including my out-of-town in-laws would ask if I noticed he had issues with eye contact. I thought they were crazy (as did close friends and immediate family). If my pediatrician had asked me during that time, when S. was just 12 months old, if he made eye contact, I would have answered with a resounding yes. If he had asked me if S. had good communication skills, I would have said ”the best” (and truly meant it).  Honestly, my naivety was so entrenched  that I have no doubt I would have convinced my pediatrician that S. was immature and I’m sure he would have agreed and said that we’d keep an eye on it until he was older. And that’s exactly what I did.

Would it have been better to have had the conversation about some of S.’s lacking social skills with my pediatrician while he was a baby? Maybe. Do I wish we could have started early intervention therapy at age 1? Yes and no. Therapy costs a fortune and in many ways, S.’s growth does sometimes happen with or without therapy. The more he matures (at his own pace), the better the results of the work we do with him.

Autism Spectrum Disorders are a very complicated set of symptoms and signs that constantly change and are hard to read. At year child’s one-year birthday, I don’t know if you really understand your child and what his or her strengths and weaknesses are (many are still just crawling around, drooling and babbling!). Labeling babies as being at risk for an ASD seems like a recipe for disaster for parents, doctors, therapists and, most importantly, this group of unique children who have so much to add to our world when they are understood to be much more than a set of characteristics on a five-minute checklist.

(Photo: Stockbyte)