UNC study could help identify autism early

UNC researchers found a brain abnormality in infants at a high risk of autism that could help identify and treat autism before symptoms arise.

The study, led by researchers at the Carolina Institute for Developmental Disabilities and published Feb. 15, used MRI scans of infants with siblings who have autism to predict which infants would be diagnosed with autism at 2 years old.

The researchers were able to accurately predict diagnoses for 80 percent of the infants.

Dr. Joseph Piven, distinguished professor of psychiatry and director of the CIDD, said the risk for autism in the general population is one in 100, but children who have siblings with autism have a risk of one in five, so studying early development in high-risk infants was an effective approach.

Brain enlargement is linked to the development of autism, according to the study. 

In the study, the infants were scanned at 6, 12 and 24 months of age, Piven said.

He said the findings present greater opportunities for treatment options.

“We might be able to detect autism before it occurs, at least in this particular population of kids with high familial risk," he said. "That opens the door to pre-symptomatic interventions.”

When autism is diagnosed at 2 to 3 years of age, the brain has already undergone significant changes. Piven said the study predicted which kids would be eventually diagnosed with autism in their first year of life.

Dr. Lauren Turner-Brown, assistant director at UNC TEACCH Autism Program and assistant professor in the department of psychiatry, said earlier prediction means children and families can access intervention services at a younger age. 

“There is a huge period of time where parents recognize some things they might not like in their child or may be going from one professional to another getting mixed messages,” she said. “There is a lot of struggle and a lot of time loss for them before they can actually get the help that they need.”

Turner-Brown said UNC TEACCH serves people across their lifespans, so seeing kids earlier would be a benefit for the program.

“We like working with really young children,” she said. “We find that while everyone can learn at any point throughout their life set, there is an early period where we feel like intervention can be particularly helpful so that would be fantastic for us.”

While the findings seem promising, there is still more research needed. Piven said the next steps would be to replicate the study, figure out what is driving it and consider ethical, legal and social questions.

“Is it good to do this, especially if we don’t necessarily have a treatment? Can we do any damage?” he said.

Piven said it is not known how this could impact high-risk children.

“We never had the opportunity to identify who is going to get autism before they get it, so if this imaging study is replicated, then we would go ahead and use it to start different trials and different interventions,” he said.

Turner-Brown said there is a little ways to go before this kind of research is available to families, but identifying autism early in life is critical.

“It’s really exciting to seeing that they are getting the results they are,” she said.

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