Early Autism Diagnosis in Mild Cases (2019 article)

In February 2019, Lisa Shuman and her colleagues published an article examining children who received an Autism Spectrum Disorder (ASD) diagnosis at 3 years old but no longer met criteria several years later. Many of the children still showed emotional/behavioral problems or learning problems. The authors suggested that milder presentations were more likely to resolve. These children may be more likely to have different emotional/behavioral disorders or learning disorders. The authors suggested that early diagnosis of ASD may serve as a “holding area” until children can develop and be diagnosed with better clarity, with regard to differentiating between several diagnostic possibilities.  It can be found in the journal of Child Neurology.

It is important to note that despite these cautions about early diagnosis for mild cases or cases where other disorders remain reasonable diagnostic alternatives, early identification and treatment for Autism remains critically important. This was discussed recently by Klintwall and Eikeseth, psychologists at Oslo and Akershus University in Norway. In their 2014 chapter in the book Comprehensive Guide to Autism, they discuss Early and Intensive Behavioral Intervention (EIBI). They note that multiple outcome studies have indicated that children who receive EIBI make greater progress in adaptive behavior and performance on cognitive testing than comparison groups.

Multiple studies have shown utility in very early diagnosis, including testing before 2 years old. For example, the Pediatrics in Review article published by American Academy of Pediatrics provides guidance to primary care physicians for early identifications procedures. The authors suggest that up to 50% of affected children could be diagnosed reliably by 14 months of age.