"On-Time Autism Intervention": A Diagnostic Practice Framework to Accelerate Access.

It is well-documented that autism can be reliably diagnosed by age two and that early signs emerge most often between 18 and 24 months. However, despite the increased awareness and focus on early diagnosis, the average age of diagnosis is over 4 years old; even later for Black children and those who are Medicaid-eligible. In this paper, we will propose a framework for accurate and accelerated autism diagnosis for children before age three. The proposed framework emphasizes a collaborative diagnostic process, which relies heavily on Birth to Three provider knowledge and expertise. Considerations for next steps are presented. This approach could increase access to diagnosis of young children soon after first signs of autism emerge.

Practice Patterns and Potential Barriers to Early Diagnosis of Autism in Bosnia and Herzegovina: A Preliminary Study.

The aim of this preliminary study was to identify the practice patterns and potential barriers to diagnosing autism in Bosnia & Herzegovina. 126 children aged 23 to 94 months with developmental concerns referred to treatment centers participated in the study. Although parents had reported developmental problems in their children usually around the age of 17 months, it took them 812 visits to professionals (> 6 visits per child) over several months (mean 16.8, range 2-52 months) to get diagnosed with any developmental disorder. Only 8 children (6.3%) received a diagnosis of autism. However, when we re-examined 110 of the 126 children, 90 of them (71%) were identified with autism. Implications of these findings are discussed.

Misteps within the development of subjectivity: autistic signs or depression in the baby? / Percalços no processo de subjetivação do bebê: sinais de risco de autismo ou depressão do bebê

RESUMO: A clínica da intervenção precoce nos leva a questionar as nuances sintomatológicas entre os sinais de risco de autismo e os da depressão no bebê. Partindo-se do conceito freudiano que associa a depressão à perda do objeto, como se poderia pensar sobre o quadro depressivo no caso dos bebês que estão em processo de construção de sua relação objetal? Em ambos os casos, trata-se de um desencontro no arranjo pulsional do laço mãe-bebê, embora com características distintas, vivenciadas, sobretudo, por meio da relação contratransferencial com o analista. A partir da exposição de dois casos clínicos, discute-se em quais aspectos o retraimento relacional autístico e o depressivo do bebê convergem e se diferenciam.

Abstract: The early intervention clinic leads us to question the symptomatic nuances between the signs of risk of autism and the signs of depression of the baby. In considering the Freudian concept that associates the depression with the loss of the object, how could we think about be regarded the depressive condition of babies who are in the process of constructing their relationship to the object? In both cases, there is a mismatch in the establishment of the impulse drive between the mother and the baby which, although being distinct experienced features, are associated to the counter transfer with the analyst. On the basis of two different clinical cases, we address under which conditions the autistic withdrawal and the depression of the baby converge and differentiate one from another.

A PRELIMINARY VOLUMETRIC MRI STUDY OF AMYGDALA AND HIPPOCAMPAL SUBFIELDS IN AUTISM DURING INFANCY.

Currently, autism spectrum disorder (ASD) is mainly diagnosed by the observation of core behavioral symptoms. Consequently, the window of opportunity for effective intervention may have passed, when the disorder is detected until 3 years of age. Thus, it is of great importance to identify imaging-based biomarkers for early diagnosis of ASD. Previous findings indicate that an abnormal pattern of the amygdala and hippocampal development in autism persists through childhood and adolescence. However, due to the low tissue contrast and small structural size of amygdala and hippocampal subfields, our knowledge on their growth in autistics in early stage still remains very limited. In this paper, for the first time, we propose a volume-based analysis of the amygdala and hippocampal subfields of the infant subjects with risk of ASD at around 24 months of age. Specifically, to address the challenge of low tissue contrast, we propose a novel deep-learning approach, i.e., dilated-dense U-Net, to automatically segment the amygdala and hippocampal subfields. Experimental results on National Database for Autism Research (NDAR) show the advantages of our proposed method in terms of segmentation accuracy. Our volume-based analysis shows the overgrowths of amygdala and CA1-3 of hippocampus, which may link to the emergence of autism spectrum disorder.

Validity of the Autism Mental Status Exam in Developmental Pediatrics and Primary Care Settings.

The Autism Mental Status Exam (AMSE) is a brief clinician-completed observational instrument that has shown promise in identifying autism spectrum disorder (ASD) in a referred sample. Our study explores the feasibility of the AMSE in both developmental pediatric and primary care samples. Fifty-three toddlers with ASD and other disabilities were scored using the AMSE and compared with 55 typically developing toddlers. AMSE scores differed significantly between ASD, non-ASD developmental disability, and neurotypical groups. A cutoff score on the AMSE of ≥5 for ASD maximized sensitivity (81.2%) and specificity (90.5%). Score differences between groups suggest that the AMSE may be useful in a clinical setting to help identify children with possible ASD.

How can clinicians detect and treat autism early? Methodological trends of technology use in research.

UNLABELLED: We reviewed original research papers that used quantifiable technology to detect early autism spectrum disorder (ASD) and identified 376 studies from 34 countries from 1965 to 2013. Publications have increased significantly since 2000, with most coming from the USA. Electroencephalogram, magnetic resonance imaging and eye tracking were the most frequently used technologies. CONCLUSION: The use of quantifiable technology to detect early ASD has increased in recent decades, but has had limited impact on early detection and treatment. Further scientific developments are anticipated, and we hope that they will increasingly be used in clinical practice for early ASD screening, diagnosis and intervention.