Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

Rebecca Grzadzinski^{1

2}, Dima Amso³, Rebecca Landa^{4

5}, Linda Watson^{6

7}, Michael Guralnick⁸, Lonnie Zwaigenbaum⁹, Gedeon Deák¹⁰, Annette Estes¹¹, Jessica Brian^{12

13}, Kevin Bath¹⁴, Jed Elison¹⁵, Leonard Abbeduto¹⁶, Jason Wolff^#¹⁷, Joseph Piven^#¹⁸

Affiliations

¹ Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA. Rebecca_grzadzinski@med.unc.edu.
² Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA. Rebecca_grzadzinski@med.unc.edu.
³ Department of Psychology, Columbia University, New York, NY, USA.
⁴ Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA.
⁵ Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA.
⁷ Division of Speech and Hearing Sciences, University of North Carolina, Chapel Hill, NC, USA.
⁸ Center on Human Development and Disability, University of Washington, Seattle, WA, USA.
⁹ Department of Pediatrics, University of Alberta, Edmonton, Canada.
¹⁰ Department of Cognitive Science, University of California, San Diego, San Diego, CA, USA.
¹¹ Department of Speech and Hearing Sciences, University of Washington Autism Center, University of Washington, Seattle, WA, USA.
¹² Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
¹³ Department of Paediatrics, University of Toronto, Toronto, Canada.
¹⁴ Department of Neuroscience, Brown University, Providence, RI, USA.
¹⁵ Institute of Child Development, University of Minnesota, Minneapolis, MN, USA.
¹⁶ University of California, Davis, MIND Institute, University of California, Davis, Sacramento, CA, USA.
¹⁷ Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA.
¹⁸ Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA.

^# Contributed equally.

PMID: 34654371
PMCID: PMC8520312
DOI: 10.1186/s11689-021-09393-y

Review

Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

Rebecca Grzadzinski et al. J Neurodev Disord. 2021.

. 2021 Oct 15;13(1):49.

doi: 10.1186/s11689-021-09393-y.

Authors

Affiliations

¹ Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA. Rebecca_grzadzinski@med.unc.edu.
² Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA. Rebecca_grzadzinski@med.unc.edu.
³ Department of Psychology, Columbia University, New York, NY, USA.
⁴ Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA.
⁵ Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA.
⁷ Division of Speech and Hearing Sciences, University of North Carolina, Chapel Hill, NC, USA.
⁸ Center on Human Development and Disability, University of Washington, Seattle, WA, USA.
⁹ Department of Pediatrics, University of Alberta, Edmonton, Canada.
¹⁰ Department of Cognitive Science, University of California, San Diego, San Diego, CA, USA.
¹¹ Department of Speech and Hearing Sciences, University of Washington Autism Center, University of Washington, Seattle, WA, USA.
¹² Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
¹³ Department of Paediatrics, University of Toronto, Toronto, Canada.
¹⁴ Department of Neuroscience, Brown University, Providence, RI, USA.
¹⁵ Institute of Child Development, University of Minnesota, Minneapolis, MN, USA.
¹⁶ University of California, Davis, MIND Institute, University of California, Davis, Sacramento, CA, USA.
¹⁷ Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA.
¹⁸ Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA.

^# Contributed equally.

PMID: 34654371
PMCID: PMC8520312
DOI: 10.1186/s11689-021-09393-y

Abstract

Autism spectrum disorder (ASD) impacts an individual's ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Conceptual framework for pre-symptomatic intervention

See this image and copyright information in PMC

References

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Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

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Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

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Abstract

Conflict of interest statement

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