WEDNESDAY, Feb. 15, 2017 -- In what they call a first, researchers say they can predict whether some infants under the age of 1 will actually develop autism in their second year. The new experimental technique, using standard brain screening, is designed to focus solely on newborns known to be at high risk for autism because they have an older sibling who has it.

Healthcare professionals may soon have a better understanding of which brain biomarkers can identify infants in a “high-risk” pool who will be diagnosed with autism spectrum disorder (ASD) thanks to a first-of-its-kind research study.

Researchers, including a team from the University of Washington, recruited hundreds of kids from around North America and used MRI scans to measure how the brains of “low-risk” infants (those with no family history of autism) compared to those of “high-risk” infants, who had at least one autistic older sibling. By looking at aspects such as brain surface-area growth rate and behavioral tests, the researchers were able to correctly identify 80 percent of the babies who would be diagnosed with autism at 2-year-old.

The study, published in the February 15 edition of Nature, was launched ten years ago to better understand autism, and identify predictors of its prevalence.

Scientists have long had evidence from head circumference studies that show that while babies with autism typically had a larger circumference, there was no measurable difference at birth. Stephen Dager, UW professor of radiology and associate director of the Center on Human Development and Disability, explained that while studies vary, they usually find that somewhere between 1 and 2-years-old there is an acceleration of brain growth in autistic children.

In this study, however, researchers took MRI scans of children sleeping at 6, 12 and 24 months of age, and found that babies who developed autism were experiencing an expansion of brain surface area as early as 6 to 12 months.

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MRI technician Mindy Dixon and Stephen Dager (left) review brain scans in order to better understand the child's brain chemistry.

MRI technician Mindy Dixon and Stephen Dager (left) review brain scans in order to better understand the child's brain chemistry.

Annette Estes, left, plays with a child at the UW Autism Center.

Annette Estes, left, plays with a child at the UW Autism Center.

They were also able to test early behavioral differences, which could be the basis for “pre-symptomatic” diagnosis of ASD, allowing healthcare professionals to look for earlier characteristics.

“We were finding differences as early as 6 months, both in terms of imaging and also behavioral differences," said Dager. "Infants at 6 months don’t have any developmental stages where we can see things particularly associated with autism."

“If we could actually look at a child’s strengths and weaknesses and not cure autism, but help them maximize their strengths, that’d be a wonderful thing.”

Though ASD affects around 3 million people in the United States alone, very little is known about its mechanisms. Typically, the earliest autism can begin to be reliably diagnosed is around 2 years old, when doctors can look at consistent behavioral symptoms.

But UW professor of speech and hearing sciences Annette Estes says the average age of diagnosis is actually closer to 4, which can leave a child without the support they need for key early years.

In the U.S., it’s estimated that one in every 68 babies develops autism, but for infants with an autistic older sibling, that number can be as high as one in five. If the study -- led by researchers at the University of North Carolina-Chapel Hill, Washington University in St. Louis, the University of Pennsylvania, and the UW -- can be replicated, that extra time could make a big difference in those high-risk populations.

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“Currently what we’re doing is waiting for kids to fall significantly behind peers and developmental levels before getting identified,” said Estes, who tested the behavioral responses of the children in the study.

“To be able to put that on its head, and identify kids who would really benefit from careful assessment, monitoring and intervention ahead of time, is exciting.”

Though autism remains a highly-individualized condition, finding these common biometric identifiers earlier means parents can better plan and tailor care for their child. Dager says the research team now hopes to build on their results by looking earlier (MRI scans at 3 months), and digging deeper, thanks to new technology.

“The technology advancement that allowed us to approach the brain with very investment than 15 or 20 years ago,” said Dager.

“Measurements and the imaging markers we're able to study now just weren't conceivable or possible ten years ago ... Now we can use functional imaging to look at how the brain talks to itself, and using the function of the brain as a mile marker.”

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