ASD: Is It Ever Too Early to Act?

Ivy_ChongAutism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders, with an estimate of one in 68 children, occurring across all racial, ethnic and socioeconomic groups. ASD is more prevalent in children than cancer, diabetes, spina bifida and Down syndrome. A growing body of research suggests that autism can be accurately diagnosed by age 2 and is stable over time. There is hope, but caregivers and professionals must act early. Extensive evidence has shown early intensive behavioral intervention significantly improves a child’s developmental outcomes—with applied behavior analysis or ABA being the ‘standard approach’ for decreasing autism symptoms and teaching new skills.

According to a recently published prospective study, parents’ concerns as early as 6 months of age can predict autism spectrum disorder in high-risk siblings. Although symptoms exist and developmental milestones are missed, caregivers who observe signs of an emerging disability are often counseled, by pediatricians and other professionals, to wait (some insurances will not cover diagnosis until 18 months). However, research in the past decade shows promise for identifying symptoms as early as 6 to 12 months. These early symptoms include diminished or no response to his/her name; reduced “spontaneous” social orienting (i.e., shifting eye gaze back and forth during interaction); reduced social “liveliness” during parent-child interaction; and impaired joint attention (e.g., ability to respond to or initiate interest with caregiver toward the same object or event through nonverbal means).

Despite these advances in detection, families often do not pursue interventions until many months or years after symptoms are first observed. However, we know that early treatment, guided by a qualified clinician, starting at a significantly younger age, can mitigate the severity of the symptoms and, in some cases, the child is virtually indistinguishable from his or her peers by the age of 3 or 4 years. Recently, researchers at the New England Center for Children have found that toddlers between 18 and 24 months make the most dramatic gains. These findings offer much-needed hope to families and indicate there is the possibility of the same dramatic results in the treatment of infants. For more information regarding warning signs, diagnosis and treatment, visit or

Ivy Chong is the director of autism services and training at The Scott Center for Autism Treatment and associate professor in the College of Psychology and Liberal Arts. She holds a doctorate in behavior analysis from Western Michigan University and is a board certified behavior analyst and licensed psychologist.

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