Training maternal child health nurses in the early warning signs of autism spectrum disorders in children aged 15 to 24 months could be the key to early diagnosis and intervention, according to an Australian psychologist.
La Trobe University Associate Professor Cheryl Dissanayake, director of the Olga Tennison Autism Research Centre, said the average age of ASD diagnosis was in children aged four but an earlier diagnosis was pivotal to early treatment and a better outcome for children to overcome social, behavioural and cognitive difficulties.
In a Victorian trial, the Social Attention and Communication Study known as SACS, 241 maternal child health nurses were trained to use a developmental surveillance approach to identify infants with an ASD through their routine assessments at eight, 12, 18 and 24 months of age.
More than 20,000 children were monitored for the early autism phenotype, marked by a lack of key behaviours, which are indicative for ASD development at each age.
The warning signs include reduced and atypical eye contact, reduced social smiles, failure to follow a point or initiate pointing, lack of imitative behaviours and limited or no pretend play.
The trial found 81 per cent of the children nurses referred to the La Trobe University team for a thorough developmental assessment were found to have autism while almost all of the remaining children had either a developmental or language delay, or both.
Dr Dissanayake, who has detailed her research in the Australian Psychological Society journal InPsych, said a variable pattern for the onset of autism meant a one-off screening was not the solution.
“We now understand that the onset of autism symptoms is variable during the first two years of life, with signs evident in some children from birth, while others may appear to be developing typically but then fail to progress, and yet others who may lose some of the skills already developed,” she stated in her article.
The success of SACS and accuracy of early clinical diagnoses
of ASDs at 24 months led to the creation of Australia’s first early diagnostic clinic for ASDs, focusing on children aged under three, at La Trobe University in July last year.
A lack of funding has meant the clinic is only open one day a week, thanks to philanthropic funding.
Dr Dissanayake said children aged two to five years in the clinic’s first intake of 20 children with an ASD had all shown major developmental gains in just one year of intervention.
“Those who were younger when they began intervention made the best progress over this time,” she stated.
“We do not know the causes of autism and we have no cure, so intervention to enhance development and reduce symptoms is of crucial importance.”