Early detection of core deficits in autism

Abstract

The goal of this review of the research literature is to discuss approaches to the early detection of autism in infancy. Early detection would enable diagnoses to be made before 18 months of age rather than at 24-30 months, the age where diagnoses start to be made now. After summarizing the criteria for a deficit to be considered "core" to the disorder, the literature on research strategies used in early detection is examined. In order to guide the design of future studies, the review then turns to an overview of what is known about the processes of early social development in typically developing children that underlie the domains in which core deficits are manifested in young children with autism. The social domains covered in the review are those that show development in typically developing infants below 18 months of age: dyadic interaction and imitation; emotion discrimination; and attachment. The review concludes that all of these areas are worthy of investigation in young children, particularly those at higher risk of showing some of the core deficits of autism such as the infant siblings of children with autism.

Imitation Assessment and Its Utility to the Diagnosis of Autism: Evidence from Consecutive Clinical Preschool Referrals for Suspected Autism

“…This finding supports the criterion of uniqueness of a core deficit in autism (Williams et al 2004). To establish the specificity of imitation problems, research is carried out that contrasts different functions and abilities across groups, testing the hypothesis that imitation problems are deficient in the autism group while other problems are not involved, or that imitation problems are specific rather than being part of a more general problem (Sigman et al 2004). Results of Williams and colleagues' meta-analysis revealed that mental delay and motor skill impairment account for some impairment but by no means for all of it.…”

“…Do imitation problems reflect a core characteristic in autism? A symptom is considered to be a core characteristic of autism if it is unique to autism, specific and universal (Sigman et al 2004). In addition, a deficit must fulfil the criteria of persistency (Hobson and Lee 1999), precedence (Rogers 1999) and broadness.…”

“…For the criterion of universality to be met, a core deficit is expected to appear during at least one age period in all individuals with autism, regardless of the severity of the disorder (Sigman et al 2004). Since in Williams and colleagues' meta-analysis the size of the imitative problem was most apparent in younger age groups, it seems a valuable idea to explore this criterion at preschool age, including children with different functional levels.…”

Joint Attention and Attachment in Toddlers with Autism

“…The social interaction and orientation problems of infants with autism may decrease the amount of attention to their mothers (Sigman et al 2004). Children with autism with a secure attachment relationship may however show more reciprocal interaction with their caregiver compared to their counterparts with a disorganized attachment relationship.…”

Matching Procedures in Autism Research: Evidence from Meta-Analytic Studies

“…The three basic requirements are universality (that is, that the deficit is manifested in all or almost all individuals with autism), specificity (that is, that the disorder involves a domain-specific deficit in this particular area), and uniqueness (that is, that the deficit is not manifested by most individuals with other clinical diagnoses) (Sigman, 1994(Sigman, , 1996Wagner, Graniban, & Cichetti, 1990;Zelazo, Burack, Benedetto, & Frye, 1996;Zelazo, Burack, Boseovski, Jacques, & Frye, 2001). In order to address these issues, researchers must carefully examine the characteristics of the groups employed in their studies.…”