Autism Symptoms early signs study

TORONTO (CP) - Jodie Kushneryk has already gone through the devastation of learning that her first child is autistic. Now she's facing the possibility her second son may also have the disabling neurological disorder. But the Brantford, Ont., mom hopes groundbreaking Canadian research that has identified early signs of possible autism in siblings could help two-year-old Landon - by giving him a head-start with behavioural therapy even before a definitive diagnosis is made.
"It's really too early yet to see if, in fact, Landon does have autism or not," said Kushneryk, noting that he's far ahead of where her seven-year-old son Lukas was at that age, but is behind in language development.
"I'm just concerned. I want some help as soon as I can."
To that end, she agreed to have Landon participate in a multi-centre study that has enrolled 200 Canadian families with an autistic child and a younger sibling. So far, the researchers have found that even at six to 12 months of age, there are certain behaviours that distinguished siblings who were later diagnosed with autism.
"Quite a significant number of children who can be diagnosed at the age of two to three do have early behavioural clues that one can detect by the age of 12 months," said Dr. Lonnie Zwaigenbaum, a developmental pediatrician at McMaster Children's Hospital in Hamilton and co-lead author of the study.
Those early signs include decreased eye contact, diminished social smiling and low social response, "so when you're playing peek-a-boo, for example, the child is not as responsive," he said Thursday. "It takes more effort to get a response."
Other signs include extreme reactivity, with the child becoming "very distressed" by people approaching or a new toy. Some children may be under-reactive, not exploring the room with their eyes or not making typical facial expressions when playing.
The researchers also found the children have a tendency to fixate on objects and have trouble with language and communication.
Zwaigenbaum said the ultimate goal of the research is to better understand the early development of autism in children within the general population and to develop interventions to help restrict disability. (Families with an autistic child have a five to 10 per cent higher risk of having another child with the condition, a rate of recurrence about 50 times higher than the general population.)
"Most of what we know about the early signs of autism at this point comes from parents looking back at what their children were like earlier in life or looking at home videotape studies," he said.
"But being able to observe for ourselves . . . allows us to get a better picture of what autism might look like earlier in life. And because siblings are at higher risk, it allows us to have the opportunity to identify some children who have autism, whereas in the general community, one would need to work with thousands of children even to identify a small number."
Autism, an incurable condition believed to be genetic in origin, affects about one in 500 individuals worldwide and is four times more common in boys than girls. Intense behavioural therapy has been found to help improve social and learning abilities, but experts say that for most autistic people, the condition continues to have some impact throughout life.
Dr. Jessica Brian, a psychologist at the Hospital for Sick Children and one of the researchers, is working with Toronto-area families in the study, assessing their youngsters for possible signs of autism.
Once specific areas of concern are determined, she and her hospital colleagues work with the child to change behaviour. For instance, if a child is wary of eye contact, they might tempt the child with a favourite toy or a tickle game, then pause to prompt visual communication.
"We would try to solicit eye contact by putting our face close to theirs and making our face animated, and as soon as the baby looks, we continue the game," said Brian, calling the therapy a form of positive reinforcement.
Much is still to be learned about autism. If children are genetically predisposed to the disorder, they're likely born with a different way of perceiving the world and interacting with people, she said.
"So we feel that if we get in sooner and teach them the most typical ways of understanding the world, we can help change the developmental trajectory they're headed on."
Researchers at Dalhousie University's IWK Health Centre in Halifax are also collaborating on the study. Preliminary results dealing with 70 children are published in this month's International Journal of Developmental Neuroscience.