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Review
. 2023 Mar;22(3):244-254.
doi: 10.1016/S1474-4422(22)00407-0. Epub 2022 Nov 22.

Prediction of autism in infants: progress and challenges

Geraldine Dawson  1 , Amber D Rieder  2 , Mark H Johnson  3
Affiliations
Review

Prediction of autism in infants: progress and challenges

Geraldine Dawson et al. Lancet Neurol. 2023 Mar.

Abstract

Autism spectrum disorder (henceforth autism) is a neurodevelopmental condition that can be reliably diagnosed in children by age 18-24 months. Prospective longitudinal studies of infants aged 1 year and younger who are later diagnosed with autism are elucidating the early developmental course of autism and identifying ways of predicting autism before diagnosis is possible. Studies that use MRI, EEG, and near-infrared spectroscopy have identified differences in brain development in infants later diagnosed with autism compared with infants without autism. Retrospective studies of infants younger than 1 year who received a later diagnosis of autism have also showed an increased prevalence of health conditions, such as sleep disorders, gastrointestinal disorders, and vision problems. Behavioural features of infants later diagnosed with autism include differences in attention, vocalisations, gestures, affect, temperament, social engagement, sensory processing, and motor abilities. Although research findings offer insight on promising screening approaches for predicting autism in infants, individual-level predictions remain a future goal. Multiple scientific challenges and ethical questions remain to be addressed to translate research on early brain-based and behavioural predictors of autism into feasible and reliable screening tools for clinical practice.

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Conflict of interest statement

Declaration of interests GD is on the Scientific Advisory Boards of Akili Interactive, Zynerba, Non-verbal Learning Disability Project, and Tris Pharma; is a consultant to Apple, Gerson Lehrman Group, and Guidepoint Global; and receives book royalties from Guilford Press and Springer Nature. GD has developed technology, data, and products that have been licensed to Apple and Cryo-cell. MHJ receives book royalties from Wiley-Blackwell and Oxford University Press. ADR declares no competing interests.

Figures

Figure:
Figure:
A 1-month-old infant looks at a face stimulus during a home-based study in which functional near infrared spectroscopy is used to measure increases and decreases in regional neural activity
See this image and copyright information in PMC

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