Thursday, April 22, 2010

Clinic Notes: The Onset of Autism

Everyone knows by now that the earlier ABA is started for children with autism the better. The problem is there are no biological markers so inferences have to be made from behavior. The categorization of autism into infantile, where the disorder is supposedly present at birth, and regressive, where development is normal until between 2 and 3 has fallen out of favor. According to one study that looked at homemade videos signs of autism were present in children latter diagnosed with regressive autism. As a clinician, I was never satisfied with this study. I think there are cases of regressive autism where signs were missed but I still think most parents are right when they tell me everything was normal until 21/2 years or so. A new study from the Kennedy Krieger Institute finds this "lost" distinctions may be vital as far as prognosis. When children with early onset of symptoms (infantile) were compared to children with later onset (regressive) it was found that children with regressive were more severely impaired and need more services. Of course, the earlier the ABA the better for the early onset children, but apparently no biological or behavioral markers for the children with regressive autism.

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