The American Academy of Pediatrics has recommended that all infants be screened for autism twice before their second birthdays. Currently, pediatricians look for the hallmark social and communication signs of autism, which include language delays and lack of interest in people.

"The finding that the unusual use of toys is also present early in life means that this behavior could easily be added to a parent check-list or quickly assessed during a visit to a pediatrician's office," Ozonoff said.

The study involved 66 one-year-old infants. Nine of the children were later diagnosed with autism. Seven of the nine children displayed significantly more spinning, rotating and unusual visual exploration of objects than typically developing children.

"We found that these behaviors were relatively rare in the contrast group, but very high in the group who later developed autism," Ozonoff said.

Current screening tests focus on social-communicative behaviors like responding to name, making eye contact and word learning. These measures accurately distinguish children developing autism from children who are developing as expected.

The average age of autism diagnosis in the United States is three years of age or older. Interviews with parents, however, have shown that signs of autism often are present long before the diagnosis is made.

"About a third of parents notice signs before a child's first birthday," Ozonoff said. "We felt that our field could do a better job at early diagnosis, so we decided to look at multiple candidates for early screening and early detection," she explained.

Ozonoff and her colleagues decided to look at repetitive behaviors that previous studies indicated developed later than two years of age. These retrospective studies, however, relied on the memory of parents whose children were ultimately diagnosed with autism.

"We wanted to directly test whether or not repetitive behaviors so characteristic of autism might actually be apparent earlier and therefore useful in early diagnosis," Ozonoff said.

In contrast to previous research, the current prospective study began with a group of 12-month olds who had not received any diagnosis. The study group included infants from families who had either an older child diagnosed with autism or an older child developing typically.

To approximate the skewed gender ratio of autism in the real world, 62 percent of the infants enrolled were male. The children in the study were presented with four objects — a metal lid, a round plastic ring, a rattle and a plastic baby bottle — one at a time for 30 seconds each while being videotaped.

Researchers blind to the outcomes coded the behaviors in the tapes. The children were screened for autism at 36 months. Ozonoff and her colleagues found that children later diagnosed with autism were more likely to repeatedly spin and rotate objects. They were also more likely to explore objects in unusual ways, like glancing sideways at them or starting intently at them for prolonged periods.

"Our results suggest that these particular behaviors might be useful to include in screening tests," Ozonoff said.

More research involving more infants will have to be done first. Ozonoff and her colleagues have already begun a larger five-year study that also includes a high-risk sibling group like the one used in the current study.

"We will also want to check that we find the same results in a random community sample," she said.

These kinds of long-term studies, Ozonoff said, are the keys to improving early detection and diagnosis of autism.

"The earlier you treat a child for autism, the more of an impact you can have on that child's future," she said.

Other study authors included UC Davis M.I.N.D. Institute researchers Gregory Young, Stacy Goldring, Megan Thompson, Sally Rogers and Suzanne Macara, who is now at Yale University. The study was supported by a grant from the National Institute of Mental Health.
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Connections Between Vision And Movement Examined By Rutgers Researcher

Medical News Today (October 9, 2008)

Related to perceived threats and to autism
A hand moves forward, but is it a friendly gesture or one meant to do harm? In an instant, we respond -- either extending our arm forward to shake hands or raising it higher to protect our face. But what are the subtle cues that allow us to interpret such movement so we can properly respond to others?

In research projects designed to assist the U.S. Department of Homeland Security and to provide deeper insight into how autistic individuals perceive others, Maggie Shiffrar, professor of psychology at Rutgers University in Newark, is examining how our visual system helps us to interpret the intent conveyed in subtle body movements.

While most autism research has focused on the difficulties in face perception, Shiffrar is one of the first researchers to examine autism as it relates to connections between visual analysis, body movement and our ability to interact with others. 

Autism -- A Lens Devoid of Emotion
Almost all people possess some autistic tendencies, explains Shiffrar, but her research shows that those with the fewest autistic tendencies "are best at detecting the weak signals provided by body movement." Thus, people with very few autistic tendencies are the best at interpreting emotion from body movement.
Working with test participants under a $750,000 grant from the Simons Foundation, Shiffrar has discovered that people with autistic spectrum disorder (ASD) tend to view other people and objects alike. It is as if they view the world through a lens devoid of emotion.  People and objects appear to hold the same level of significance.

People with few autistic tendencies, on the other hand, have visual systems that analyze human movement and the movement of objects differently. As a result, when presented with limited information they find it easier to identify people over objects.

Once rare, autism in the United States has reached epidemic proportions. The U.S. Centers for Disease Control and Prevention estimates that autism today affects about one in every 150 children.

In her Research on Autism at Rutgers (ROAR) lab, Shiffrar and her team videotape people's body movements with lights attached to the major joints and then show research participants only the movement of the lights. Lights also are attached to objects such as a moving tractor or a dog and those light movements too are shown to participants.

Those with ASD tend to identify people and objects with an equal rate of accuracy, while those with few autistic tendencies are much better at identifying people and less able to identify objects from point-of-light representations.

"The way people move their bodies tell us volumes about their actions, intentions and emotions. To interact well with others, we need to be able to perceive this all accurately," says Shiffrar. "What we hope to determine through our research is whether people with ASD have trouble perceiving human movement because they avoid human contact in order to function, or if it is their visual system that is treating people as objects."

Previous research has revealed that the part of the brain - the amygdala - involved in emotion communicates with that part of the brain involved in the perception of human movement. This connection is impaired in people with autism and could be what makes it difficult for them to perceive other people's emotional states from their actions. Should that be the case, it may become possible to develop training programs for people with ASD to help them perceive and understand the intentions and emotional states of people from their body movements.
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Toddlers' Focus On Mouths Rather Than Eyes Is Predictor Of Autism Severity

ScienceDaily (October 6, 2008)

Scientists at Yale School of Medicine have found that two-year-olds with autism looked significantly more at the mouths of others, and less at their eyes, than typically developing toddlers. This abnormality predicts the level of disability, according to study results published in the Archives of General Psychiatry.

Lead author Warren Jones and colleagues Ami Klin and Katelin Carr used eye-tracking technology to quantify the visual fixations of two-year-olds who watched caregivers approach them and engage in typical mother-child interactions, such as playing games like peek-a-boo.

The researchers first studied 7 male and 10 female newborns. Each baby sat on an experimenter's lap, eyes level with the center of a screen. A series of pairs of female faces then appeared on the screen. In each pair, the same woman looked directly at the child in one image and averted her gaze to the right or left in the other. Video cameras monitored the babies' eye movements.