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Combination of early detection, timely treatment hold promise for autism

April 03, 2007

Emerging genetic research may help scientists recognize children with autism at a younger and potentially treatable age, according to an editorial in the April issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The issue is devoted to studies of autism spectrum disorders.

Children and adults with autism, a chronic developmental disorder, have difficulty with social and language skills and often display repetitive behaviors, according to background information in the articles. Symptoms usually appear by age 3. Much progress has been made in understanding autism and related conditions—known collectively as autism spectrum disorders—in the past 15 years. Still, significant mystery continues to surround its risk factors and possible causes, presenting challenges to scientists working to develop effective treatments.

"As autism susceptibility genes are discovered, the hope is that such risk genes—in combination with other behavioral, electrophysiologic and magnetic resonance imaging indices—might allow for very early identification of infants at risk for autism, thus offering the opportunity to prevent the full-blown syndrome," writes Geraldine Dawson, Ph.D., of the Autism Center at the University of Washington, Seattle. "In the meantime, behavioral interventions that are appropriate for very young children with autism are becoming increasingly sophisticated and effective, at least for a substantial subgroup of children with this disorder."

"Thus, a combination of very early identification and early behavioral intervention holds promise for significantly altering the course of brain and behavioral development and outcome in individuals with autism," she continues.

The autism theme issue of the journal "highlights new approaches to the early identification and treatment of autism, and the associated financial and emotional costs to families and society," Dr. Dawson writes. Papers published in the issue find that:

- Older fathers and mothers may be at increased risk of having a child with an autism spectrum disorder

- In addition to maternal and paternal age, low birth weight, a shorter pregnancy and a period during birth when the baby does not get enough oxygen may be associated with an increased risk for autism spectrum disorders

- Yearly health care expenses for individuals with autism spectrum disorders increased 20.4 percent per patient between 2000 and 2004, from $4,965 to $5,979

- Nearly one-third of parents do not appear to comply with instructions given when their children screen positive for problems with social development

The findings of the last two studies highlight the need for improved assistance to families dealing with this condition, write David J. Schonfeld, M.D., and Patty Manning-Courtney, M.D., of the Cincinnati Children's Hospital Medical Center, Ohio, in a second editorial. "While the next decade holds much promise for a better understanding of autism etiology and treatment, there is much to be done today at every level of health care and throughout our society to identify children with autism spectrum disorders early in their development so that we can provide ready access to needed services and support for their families," they conclude.

JAMA and Archives Journals