New Early Clue to Autism

Autism Possible in at-Risk 1-Year-Olds That Don't Respond to Their Names

Medically Reviewed by Louise Chang, MD on April 02, 2007
From the WebMD Archives

April 2, 2007 -- Babies that don't respond to their names by age 1 likely have a developmental abnormality -- perhaps even autism, a MIND Institute study shows.

"Failure to respond to name at the well-child 1-year checkup may be a useful indicator of children who would benefit from a more thorough developmental assessment," suggest Aparna S. Nadig, PhD, of the University of California Davis MIND Institute in Sacramento, and colleagues.

Even so, not all of these children will fail to develop normally. And just because a 1-year-old can respond to his or her name doesn't mean that child won't develop autism.

But the study marks a big step forward as researchers look for ways to identify autism -- in all its many forms -- as early as possible. That goal has become vastly more important in recent years. Researchers have found that autism can be far less severe in kids who get early treatment, says Geraldine Dawson, PhD, director of the Autism Center at the University of Washington in Seattle.

"The really exciting thing is that by beginning early we are able to prevent the full-blown autism syndrome," Dawson tells WebMD. "If we can work with a baby at the time those brain systems are developing, we think they will be much more responsive to treatment."

The Nadig study and Dawson's editorial appear in autism-themed April 2007 issue of Archives of Pediatrics & Adolescent Medicine.

Babies at Risk of Autism

Nadig and colleagues studied 55 6-month-olds and 101 1-year-olds considered "at risk" of autism because they had an older brother or sister already diagnosed with autism. They also studied 43 6-month-olds and 46 1-year-olds not at risk of autism as a control group.

They gave the babies a simple test. The child sat at a table, either in a baby seat or in its mother's lap. As the baby played with a toy, a researcher stood behind the child and called its name in a normal voice. If the child did not stop playing with the toy and turn to make eye contact with the stranger, the researcher called the child's name again. Each child got three chances to respond.

At age 6 months, 82% of the babies in the control group responded to their names on the first or second call. By age 1 year, all of these kids responded to their names on the first or second call.

It was a different story for the at-risk kids. At age 6 months, only 66% of the kids responded to their name on the first or second try. And at age 1 year, only 86% of the at-risk kids responded on the first or second call.

Can this really mean anything? At age 2, developmental problems appeared in three out of four kids who had failed the name test at age 1.

The researchers note that this test can by no means identify all children who will experience developmental problems. And as it cannot rule out such problems, Dawson says it isn't, by itself, a sure sign of trouble.

"There are a lot of reasons why a child might not turn to its name," Dawson says. "The idea is to develop a variety of behavioral indicators, such as failure to imitate, failure to communicate through babbling, failure to make eye contact, and failure to respond to name, that should come online in the last half of the child's first year. If they don't, these are good indicators that a child may have autism."

Behavioral tests are only one possibility. Dawson's team is using an electroencephalograph (EEG) to look at how infants' brains respond to certain stimuli such as speech or social interactions. Other researchers are looking at genetic factors that may predict autism.

Soon, Dawson says, it will be possible to identify very young children at risk of autism. When that happens, she hopes to be ready to treat them.

"We have been developing interventions for 12-month-old infants. And this summer we will initiate a trial of children at 8 months of age," she says. "We are trying to stay ahead of the curve, because down the road these babies are going to be identified, and it is imperative we have something to do for them."

Show Sources

SOURCES: Nadig, A.S. Archives of Pediatrics & Adolescent Medicine, April 2007; vol 161: pp 378-383. Dawson, G. Archives of Pediatrics & Adolescent Medicine, April 2007; vol 161: pp 411-412. Geraldine Dawson, PhD, professor of psychology; director, Autism Center, University of Washington, Seattle.

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