Early Diagnosis and Earliest Intervention in ASD

88 Pages·2012·3.06 MB·English

by  Sally J. Rogers

Early Diagnosis and Earliest
Intervention in ASD
Sally J. Rogers, Ph.D.
ASHA Annual Conference
San Diego, CA Nov 18, 2011
Acknowledgements
Sally Ozonoff
NIMH R01 MH 068398 (Ozonoff)
Laurie Vismara NICHD U19 HD 85468 (Rogers)
NIMH R01 MH 081757 (Rogers)
Gregory Young
NICHD R21 065275 (Rogers)
Geraldine Dawson
NIMH U54 MH66399 (Dawson)
Annette Estes
NIDCD DC R03 05574 (Rogers)
Cathy Lord OAR, MIND (Vismara)
OSERS (Rogers)
Annette Fitzpatrick
Autism Speaks, NAAR, CAN
Marian Sigman
MIND Institute
Ted Hutman
Coleman Institute
Maria Rocha
Children’ Miracle Network
Jamie Winter John and Marcia Goldman Foundation
Giacomo Vivanti
Costanza Colombi
Thank you!
Children and families
Kathy Reis, S/LP
Terry Hall,S/LP
Amy Donaldson,S/LP
Aimee Bord,S/LP
Amy Wetherby,S/LP
Deborah Hayden,S/LP
Rebecca Landa,S/LP
Paul Yoder,S/LP
Why focus on earlier
detection and treatment?
Mandell et al., 2005
The gap between symptoms
and diagnosis
Mean age of first parental

concern = 18 – 19 months
Mean age of autism diagnosis in

USA = 34 – 61 months
The gap between diagnosis
and treatment 1-2 year gap
The efficacy of earlier
intervention: IQ and language
The fear that lost time is lost
potential n = 965
Autism Before Age 2
Retrospective Before First
Studies, Age 1 – 2 Birthday
(n=8)
Response to name  ?
Looking at faces / Gaze  ?
Joint attention  ?
Shared affect  ?
Stereotyped behaviors ? ?
Regulatory / ? ?
Temperament
Infant sibling studies – watching
autism develop
Need to see what onset looks like in the lab
Autism risk in sibs 5%
Best group to study longitudinally
Goals:
How early can we diagnose accurately?

What markers are predictive?

How much variability?

Recruitment between 6- 12 months - over 500 infants
Evals: 6 24 7 yrs
mo mo
66 12 18 36
mmoo mo mo mo
Recurrence risk in multiplex families
Ozonoff et al, 2011
N=664
Enrolled 6 mon, dx 36
Overall rec rate 18.7%
26% boys, 9% girls
Simplex rate 13%
Multiplex rate 32%
Risks are double for
multiplex families
Proband IQ and ADOS
score – no effects
What about other problems?
(Ozonoff,
Hutman, et al )
High-Risk Sibs 224 infant sibs
Male Female 124 controls
Enrolled at 6 mon
Autism/ASD 28% 5%
Dx at 36 months
Other Delays 35% 16%
No Concerns 36% 79%
Total 63% 21%
Affected
Is autism primarily a social-
communicative disorder?
Jt attn
Response to name
Object Exploration Task (12 Months)
4 objects that afford
both typical and
unusual usage
Coded 8 uses of
objects