Autism
An AHFMR researcher is looking for ways to diagnose autism earlier.
One out of every 150 children in Canada has autism spectrum disorder. Yet, because of the shortcomings of current diagnostic methods, autistic children usually aren't identified until the age of four or five. Consequently, their access to any type of systematic treatment is delayed.
In the hope that children will benefit from earlier diagnosis, AHFMR Scholar Dr. Lonnie Zwaigenbaum embarked several years ago on an ambitious study-looking for early behavioural signs of autism in infants.
Autism is a disorder involving the development of the nervous system. Some of the best-known symptoms are delays in language development; difficulties in understanding and participating in social relationships; and preoccupations with repetitive tasks or behaviours. Autism is thought to develop in the womb; however, Dr. Zwaigenbaum notes that children with the disorder often seem typical in their first few months. "But then the more obvious difficulties in social engagement and communication skills may emerge in the latter half of the first year of life."
In an attempt to identify effective predictors of an autism diagnosis, Dr. Zwaigenbaum and his colleagues chose to study the younger siblings of children already confirmed as autistic. The siblings' own risk of developing the disorder was considered to be about 9%, significantly higher than that for the general population.
Infants in this high-risk group were assessed on a variety of behavioural measures, such as their ability to track visual stimuli, their response to communication, and their overall temperament. They were tracked from the age of six months to the age of three years, at which point they were independently evaluated for autism. The early results of this study showed that, by the time they were a year old, children who would later be identified as autistic could be distinguished from those who would not receive such a diagnosis. Quite a significant finding.
Since his arrival in Edmonton in 2006, Dr. Zwaigenbaum has focused on two key projects made possible by AHFMR funding. The sibling project-is set to continue, but with some new components. Dr. Zwaigenbaum hopes to begin brain-imaging work on this high-risk infant group to compare early behavioural signs of autism with changes in brain development.
For his second major research project, Dr. Zwaigenbaum will look at pre-school children already assessed as autistic. He hopes to identify the types of treatment that will put these kids in the best possible position to make the transition to school. The provinces of Nova Scotia, Quebec, Ontario, and British Columbia are involved in this study. Since each province provides a different level of funding for treatment of children with autism, Dr. Zwaigenbaum thinks it will be possible to compare the different treatment models to see whether they lead to differences in progress and outcomes.
He is also working with a group of colleagues to study environmental factors that might play a role in the development of autism. He wants to know how these factors interact with genetic susceptibility. Early research with twins showed that, if a child has autism, an identical twin is more likely to develop the disorder than is a fraternal twin. In other words, genetics plays a role-but it probably doesn't tell the whole story.
Dr. Zwaigenbaum's passion for autism research emerged during his early training. His respect for autistic children and their families, and his understanding of the significant daily challenges they face, is readily apparent. He is also seeking insights into the nature of this disorder, about which so much remains unknown.
"There's certainly a lot we still need to learn. It's the interesting clinical questions, as well as a personal interest in helping kids with autism and their families, and the enjoyment of working with them, that brought me to this field."