Early Identification and Interventions for Autism Spectrum Disorder: Executive Summary.

Abstract

* Abbreviations: ASD — : autism spectrum disorder DSM-5 — : Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition M-CHAT — : Modified Checklist for Autism in Toddlers Autism spectrum disorders (ASDs) are neurodevelopmental disorders characterized by impaired social communication skills and isolated areas of interest.1 The current prevalence of these disorders is estimated to be 1 in 68,2 and recent estimates of the risk of recurrence in families with at least 1 child diagnosed with ASD are 10% to 19%.3–5 Advances have been made in identifying genetic variants that can account for biological vulnerability to ASD,6,7 although recent studies examining patterns of heredity implicate environmental factors and potential gene-by-environment interactions.8 Although the exact etiology remains unknown in most families, some researchers suggest that the pathogenesis of the disorder begins during prenatal life.9,10 It is likely that ASD is heterogeneous in its etiology as well as in its clinical presentation.11 The American Academy of Pediatrics has recommended screening for ASDs at 18 and 24 months of age,12 but recent research suggests that atypical behaviors may be detectable in some children at even younger ages.13,14 However, we are still learning how the timing and developmental course of early ASD symptoms vary across children and how best to detect such symptoms across the continuum of children seen in community practice. In addition, reports15 that early intervention can improve developmental and behavioral outcomes in infants and toddlers have lent urgency to identifying children across the autism spectrum at an earlier age. Advances in genetic, neuroimaging, and other neurobiological research have also raised the potential of biomarker screening. Given the progress in these areas, a review of the current state of the science on early identification, screening, and intervention of ASD was warranted. These issues were the focus of an international, multidisciplinary panel of clinical practitioners and researchers with expertise in ASD and developmental … Address correspondence to Lonnie Zwaigenbaum, MD, Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Ave, Edmonton, AB, Canada T5G 0B7. E-mail: lonniez{at}ualberta.ca