Title : Bridging the gap between early detection of Autism Prodrome in infants and intervention: Clinical and study perspectives
Introduction: Clinicians and researchers increasingly realize the importance of early intervention for autism. Early intervention through the use of suitable stimulation may minimize the severity of the phenotypic presentation of autism during infancy when neural connections are being developed. However, intervention is contingent upon a diagnosis of autism – which in most developed countries occurs above the age of 24 months – resulting in missing a critical therapeutic opportunity for early intervention. This study aimed to detect the prodromal variables that may characterize significant risk for the later development of autism, in order to propose therapeutic strategies.
Methods: This study examined variables among 110 infants from various countries diagnosed with autism at age 2-3 years. Analysis was conducted of home videos recorded during the infants’ first 15 months of life. Developmental information was collated via parental questionnaires. Data was analysed in terms of individual variables and combinations of variables.
Results: Eight prodromal variables were exhibited among 89% of the infants participating in this study: lack of eye contact (77.3%); excessive passivity (44.5%); lack of reaction (44.5%); motor development delay (33.6%); refusal to eat (20.9%); excessive activity (28.2%); head circumference (12.7%); aversion to touch (10%). Cluster analysis of combinations of variables was significant, e.g. a combination of lack of eye contact with lack of reaction (37.3) and lack of eye contact with excessive passivity (35).
Conclusions and outcomes: The results of this study indicate that detecting the prodrome of autism depends primarily on the ability to identify various combinations of indicative symptoms. The variables elicited by this study provide the basis for an early assessment scale for prodromal variables associated with autism. The variables provided the basis for developing the Early Symptoms of Pre-Autism Screening Scale in Infants (ESPASSI©), which is applied clinically for infants between 5-15 months. A pilot validation study at Ichilov Hospital examined the clinical efficacy of ESPASSI©. Effective application of this screening scale is of utility in bridging the divide between early assessment and intervention. The identified variables contribute the foundation for therapeutic strategies targeting infants at high risk for autism during the very early neurodevelopmental stages.