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Detecting Autism Earlier

My son Nick is autistic. My wife and I first began noticing something was off when Nick was 18 months old, but our pediatrician said not to worry, he's just developing slowly, let's see where he is in six months. When the pediatrician repeated that wait-and-see advice six months later, we ignored it and got Nick diagnosed at Children's Hospital Boston (and got another pediatrician).

Nick is now 13 and lives full-time in a residential facility dedicated to kids with autism -- his challenges are that severe. To this day, we wonder how much further along Nick would be today if it had been as clear to his doctor as it was to us that something was seriously wrong, and we had gotten him diagnosed at 18 months rather than at two and a half. With autism, the earlier the intervention, the greater the chances for lessening the often devastating impact of this little-understood disorder.

Now, as scientists report in a new study published online in the Proceedings of the National Academy of Sciences on July 19, a new technology that analyzes vocalizations in very young children offers hope of early screening of kids like Nick for autism, as well as for typical children who suffer from a language delay.

Using the technology, the research team, led by D. Kimbrough Oller of the School of Audiology and Speech-Language Pathology at the University of Memphis, discovered that it could differentiate between the pre-verbal vocalizations of typically developing children and those of children with autism or language delays. They could even tell apart, though not with as great an accuracy, the utterances of those with autism from those with speech delay.

With parents' permission, the team placed all-day recording devices weighing less than three ounces in specially designed pockets in their child's clothing. The child then went about his or her daily life at home. Beginning in 2006, the team made nearly 1,500 recordings of 232 children, totaling over three million individual utterances. The technology is able to distinguish a child's vocalizations from those of her parents and siblings, TVs and other background noises, even the child's own cries and gut rumbles.

Previous studies had indicated that children with autism have a strikingly different vocal signature than typically developing children. But the technology was not in place to analyze massive acoustic datasets automatically and parse various parameters that could reveal those differing signatures. Besides showing potential for enhancing basic research into linguistic development, the new technology, known as LENA (for Language ENvironment Analysis), offers proof of concept that this kind of analysis can now be done, with promise for earlier detection.

"This technology could help pediatricians screen children for ASD [autism spectrum disorders] to determine if a referral to a specialist for a full diagnosis is required and get those children into earlier and more effective treatments," says Steven F. Warren, a coauthor of the PNAS paper, in a news release put out by his affiliation, the University of Kansas.

If the technology becomes widely available, parents of toddlers who show signs like my wife and I observed in Nick back in 1998 will be most grateful.

(To learn more of Nick's story, click here and go to the earliest dated entry, "All About My Son." Also feel free to share your own story about autism or other disorders on the spectrum.)

User Comments:

Hello.......I'm delighted to see you working for quicker diagnosis. And saddened to know we have yet one more boy with autism.

I wish you and others would get as excited toward Prevention of Autism and the ASD side of life. From all I know I believe we could prevent at least 2/3 of all future problems Dx as autism and it would not be too tough to accomplish.

I believe at the same time we would prevent about 2/3 or more of childhood asthma, ADD/ADHD and some other childhood problems.

Wouldn't it be great to do that?

Joyce, it saddens me to see yet another person disrespecting people with ASD - and their parents. My son has autism, and I wouldn't trade him for the world. Autism isn't a horrible "worse than death" disorder that should sadden you, and while early diagnosis increases the likelihood of a more independent life, autism itself is not as bad as you would have people believe. Since autism is most likely rooted in genetic development, the most likely cure will be abortion. So, no, I don't think prevention is the key.

My son would be extremely hurt to read that someone is saddened by his existence. He also gets very upset when people can't look past his autistic symptoms to see the person he is. I hope you will think better of autistic people before making such hurtful comments about them in the future.

Amazing! I was just thinking and hoping for a study such as this. My son is non-verbal, but he vocalizes. It would have been interesting to have him participate in this study.

I am sorry to hear about your son's situation. An autism diagnosis brings a lot of heartbreak with it, and my heart goes out to you and your family.

My first thought is that effective, early screening is already available - and it requires no technology. It's called the M-CHAT. If your pediatrician (and mine) had done this simple screen, our sons would have been diagnosed much earlier, and potentially had better outcomes. Most pediatricians still do not do this early, sensitive screen - please work to make this part of standard care at well checkups during the second year of life.

My second thought is that this technology seems to be based on the idea that a child is predestined to have autism - it disregards an environmental trigger. Since I don't believe in genetic epidemics, I think there are potential problems here.

What were the signs that you noticed early on? I wish this had been explained. Would also be helpful for those parents who are wondering. I think further info about the research and it's results would have been nice. How are the vocalizations different? Describe them? Not only would parents like to know but so would retired Speech paths.

I am bothered by your cavalier treatment of your decision to place your child in an institution. I am the parent of an autistic child and could think of absolutely no circumstances that would cause me to ship her off, and I am a single parent with a neurotypical child as well. I have lost my job due to the need to take time off to care for her during the work day, despite my use of the FMLA. I still could never send her to be raised by people who are not her family. She is a bright and funny child who has come an incredibly long way since her diagnoses, and may one day be able to live on her own. This didn't happen overnight, it took hard work from the both of us and a team of psychiatrists, psychologists, counselors and teachers. But if she needs to live with me for the rest of her life I'll be okay with that, so long as she knows she is loved.

I'm very bothered by the negativity of some of the respondents here. Heather, we casual readers are not aware of the limitations that this boy living in a residential treatment facility is experiencing. Why do you doubt his father's intentions? I doubt his attitude toward placing a child away from home came about in a "cavalier" manner. Perhaps this is how the young man will best get the intervention services that will enable him to live more independently at home later. Kudos to you for all you have done with your child, but as you know, "autism" doesn't define every child's needs, ability, personality, or family structural dynamic.
To Cherie, how harsh your reply to Joyce! No good comes from the deliberate misunderstanding of people's intents. Her position does not seem to me that she is sorry for a child's existence, just that the child has to endure more challenges than a child without autism. No one suggested that any child should have been aborted.

It is incredible the technology they are starting to come out with, and the type of genetics they are tracing back to family members. My hope is that with an increase in awareness, the parents will be more alert to possible symptoms.

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