Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants

Author:

Zwaigenbaum Lonnie1,Bryson Susan2,Lord Catherine3,Rogers Sally4,Carter Alice5,Carver Leslie6,Chawarska Kasia7,Constantino John8,Dawson Geraldine9,Dobkins Karen6,Fein Deborah10,Iverson Jana11,Klin Ami7,Landa Rebecca12,Messinger Daniel13,Ozonoff Sally4,Sigman Marian14,Stone Wendy15,Tager-Flusberg Helen16,Yirmiya Nurit17

Affiliation:

1. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

2. Department of Pediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada

3. Department of Clinical and Developmental Psychology, University of Michigan, Ann Arbor, Michigan

4. Department of Psychiatry and Behavioral Sciences, University of California, Davis, California

5. Department of Psychology, University of Massachusetts, Boston, Massachusetts

6. Department of Psychology, University of California, San Diego, California

7. Department of Psychology, Yale University, New Haven, Connecticut

8. Department of Psychiatry and Pediatrics, Washington University, St Louis, Missouri

9. Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina

10. Department of Psychology, University of Connecticut, Storrs, Connecticut

11. Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania

12. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland

13. Department of Psychology, University of Miami, Miami, Florida

14. Department of Pediatrics and Psychology, University of California, Los Angeles, California

15. Department of Pediatrics and Psychology, Vanderbilt University, Nashville, Tennessee

16. Department of Psychology, Boston University, Boston, Massachusetts

17. Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel

Abstract

With increased public awareness of the early signs and recent American Academy of Pediatrics recommendations that all 18- and 24-month-olds be screened for autism spectrum disorders, there is an increasing need for diagnostic assessment of very young children. However, unique challenges exist in applying current diagnostic guidelines for autism spectrum disorders to children under the age of 2 years. In this article, we address challenges related to early detection, diagnosis, and treatment of autism spectrum disorders in this age group. We provide a comprehensive review of findings from recent studies on the early development of children with autism spectrum disorders, summarizing current knowledge on early signs of autism spectrum disorders, the screening properties of early detection tools, and current best practice for diagnostic assessment of autism spectrum disorders before 2 years of age. We also outline principles of effective intervention for children under the age of 2 with suspected/confirmed autism spectrum disorders. It is hoped that ongoing studies will provide an even stronger foundation for evidence-based diagnostic and intervention approaches for this critically important age group.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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