Early Manifestations of ASDAccording the Diagnostic and Statistical Manual (DSM-IV-TR)
Autism must be identified before the age of three years of age. Although there is consensus that signs of Autism appear before the age of three, when does it first appear and why? The existing body of research literature indicates that the earlier treatment is initiated, the better the prognosis and results of the intervention(s).
The introduction of early
intervention programs counts on cerebral plasticity (the ability of the brains neurons to adapt, grow, and compensate). Young children up through the ages of 6 and 7 have been shown to have great cerebral plasticity; retaining the existing brain neurons that continuously make new and adapted connections in response to the child’s interactions with his or her environment. The existence of the so-called critical periods (birth through the age of 7) has been widely accepted and demonstrated, from the point of view of neurobiology. If determined synaptic connections are not made early in development, it is improbable that they will be made later. This has enormous negative implications for the development of the child as they go into adulthood.
For this research article, Perez, Gonzalez, Comi, and Nieto (2007) utilized 39 relevant studies published since 1975. The following are the major conclusions the authors were able to draw out of the analysis of these studies.
At what age are the first symptoms observed?First symptoms are generally observed by the parents between one-and-a-half and two years of age. It is also probable that the earliest symptoms appear before the parents are aware that something is wrong. Children with cognitive impairment exhibit signs of cognitive impairment before those with autism and tend to have different characteristics. Overall, the research literature suggests that early signs of autism are difficult to observe or detect before the close of the first year.
What are the first symptoms?The first symptoms appear to be social, interpersonal and intersubjective factors. Conjoint attention skills such as eye contact, looking at the face, object indicating behaviors, pointing, orienting to name, etc., are all important factors. Failures and differences in attending to social stimuli are detected and are seen together with differences in shared attention frequently.
Some aspects associated with sensory and perceptive anomalies, such as reduced capacity for inhibitory control and difficulties in changing the focus of attention, centering on objects or parts of objects over prolonged periods of time, have also been shown as early symptoms,
How is the disorder presented and what is its course?The most frequent to be observed in the majority of children with autism is the regressive type, in which the children experience a period of normal development until approximately a year to a year-and-a-half.
A progressive and fluctuating type has also been described in the literature, which may support the hypothesis of a similar developmental sequence, at least with respect to communication skills.
Can a relationship be established between time of onset and prognosis?This review did not establish a clear and consistent relationship between time of onset and prognosis of the disorder. No clear relationship was able to be established between age at presentation and severity of symptoms or between the age at presentation and other variables such as IQ and educational level of the parents.
What are the differences between normal developing children and children with Autism?Differences between normally developing children and children with Autism are clearly observed from the first year-and-a-half and beyond. Before the end of the first year, the differences were few. Differences become more evident when children begin walking between 31 and 42 months. Normally developing children spend much more time inventing new means for new ends, while autistic children spend more time repeating the same actions. Goal directed behaviors are reduced and continuous action is increased. Differences are also found in orientation tasks, temperament and receptive and expressive language.
When comparing development of children with Autism and Mental Retardation, children with Autism demonstrate an unusual response to sounds.
Comparing children with language disorders and children with Autism, the most distinguishing symptoms between the two groups are Stereotypic behaviors, isolation and scarce eye contact.
ReferencesPerez, J.M., Gonzalez, P.M., Comi, M.L., Nieto, C. (2007). Early manifestations of autistic spectrum disorder during the first two years of
life. In Perez, J.M., Gonzalez, P.M., Comi, M.L., Nieto, C., New developments in autism: The future is today, (pp. 33-57). London, UK:
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