Abstract

The ability to determine an infant's likelihood of developing autism via a relatively simple neurological measure would constitute an important scientific breakthrough. In their recent publication in this journal, Bosl and colleagues claim that a measure of EEG complexity can be used to detect, with very high accuracy, infants at high risk for autism (HRA). On the surface, this appears to be that very scientific breakthrough and as such the paper has received widespread media attention. But a close look at how these high accuracy rates were derived tells a very different story. This stems from a conflation between "high risk" as a population-level property and "high risk" as a property of an individual. We describe the approach of Bosl et al. and examine their results with respect to baseline prevalence rates, the inclusion of which is necessary to distinguish infants with a biological risk of autism from typically developing infants with a sibling with autism. This is an important distinction that should not be overlooked.Please see research article: http://www.biomedcentral.com/1741-7015/9/18 and correspondence article: http://www.biomedcentral.com/1741-7015/9/60

Highlights

  • In some ways, scientists investigating early autism (ASD) face similar problems to those investigating climate change: by the time that we are certain of our results, it may be too late to do anything about it

  • The central claim of their paper is not that EEG can be used to detect a potential biomarker for autism; it is that EEG can be used to detect a potential biomarker for infants at “high risk” for autism (HRA)

  • The media-friendly finding provided by Bosl and colleagues was that a non-invasive neurological measure could be used to distinguish between high risk for autism (HRA) infants and non-HRA infants with around 80% accuracy, and sometimes higher

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Summary

Introduction

Scientists investigating early autism (ASD) face similar problems to those investigating climate change: by the time that we are certain of our results, it may be too late to do anything about it. Like good medicine, should be predictive and preventative. It is not possible to diagnose autism in early infancy because it is defined by behavioral criteria that are not manifest until after the first or second birthday (for example, language impairments).

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