European Child & Adolescent Psychiatry

, Volume 14, Issue 2, pp 65–72

What distinguishes autism spectrum disorders from other developmental disorders before the age of four years?

  • Anegen Trillingsgaard
  • Ester Ulsted Sørensen
  • Gerda Němec
  • Meta Jørgensen
ORIGINAL CONTRIBUTION

Abstract

The increasing recognition of the benefits of early intervention for children with autism spectrum disorder (ASD) stresses the importance of early identification of children who might benefit from those programs. However, in the early years of life it may be difficult to distinguish children with ASD from children with other developmental disorders. The aim of the present study was to identify behavioural patterns that could facilitate this differentiation. Prior to diagnostic assessment, 2- and 3-year-old children (n=30), all referred to a clinic for “possible autism”, were observed in a semi-structured play interaction, and their parents were interviewed about the children’s early development from 0 to 24 months. Following diagnostic assessment, the 17 children fulfilling the ICD-10 criteria for ASD were compared to the 13 children diagnosed with other developmental disorders (outside the autism spectrum). On the basis of parent reports only a few distinguishing signs of ASD were found before 24 months of age. On the basis of professional observations in a semi-structured play interaction several distinguishing signs were found for the 2- and 3-year-olds; smiles in response, responds to name, follows pointing, looks to “read” faces, initiates requesting verbal and nonverbal behaviours, and functional play.

Key words

autism spectrum disorder other developmental disorders early identification distinguishing features 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Adrien JL, Faure M, Perrot A, Hameury L, Garreau B, Barthelemy C, Sauvage D (1991) Autism and family home movies: Preliminary findings. J Autism Devel Disord 21:43–49Google Scholar
  2. 2.
    Adrien JL, Lenoir P, Martineau J, Perrot A, Hameury L, Larmande C, Sauvage D (1993) Blind ratings of early symptoms of autism based upon family home movies. J Am Acad Child Adolesc Psychiatry 32:617–626Google Scholar
  3. 3.
    Adrien JL, Perrot A, Sauvage D, Leddet I, Larmande C, Hameury L, Barthelemy C (1992) Early symptoms in autism from family home movies. Acta Paedopsychiatr 55:71–75Google Scholar
  4. 4.
    American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders 4th Edn (DSMIV). American Psychiatric Association, Washington, DCGoogle Scholar
  5. 5.
    Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A (2000) A screening instrument for autism at 18 months of age: A 6-year follow-up study. J Am Acad Child Adolesc Psychiatry 39:694–702Google Scholar
  6. 6.
    Baranak GT (1999) Autism during infancy: A retrospective video analysis of sensory-motor and social behaviors at 9–12 months of age. J Autism Devel Disord 29:213–224Google Scholar
  7. 7.
    Baron-Cohen S, Allen J, Gillberg C (1992) Can autism be detected at 18 months? The needle, the haystack, and the CHAT. Br J Psychiatry 161:839–843PubMedGoogle Scholar
  8. 8.
    Baron-Cohen S, Cox A, Baird G, Swettenham J, Drew A, Nightingale N, Morgan K, Charman T (1996) Psychological markers of autism at 18 months of age in a large population. Br J Psychiatry 168:158–163Google Scholar
  9. 9.
    Bernabei P, Camaioni L, Levy G (1998) An evaluation of early development in children with autism and pervasive developmental disorders from home movies; preliminary findings. Autism 2:243–258Google Scholar
  10. 10.
    Charman T, Baird G (2002) Practitioner Review: Diagnosis of autism spectrum disorder in 2- and 3-year-old children. J Child Psychol Psychiatry 43:289–305Google Scholar
  11. 11.
    Charman T, Swettenham J, Baron-Cohen S, Cox A, Baird G, Drew A (1998) An experimental investigation of socialcognitive abilities in infants with autism: Clinical implications. Infant Ment Health J 19:260–275Google Scholar
  12. 12.
    Cox A, Klien K, Charman T, Baird G, Baron-Cohen S, Swettenham J, Wheelwright S, Drew A (1999) Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Eur Arch Psychiatry Neurol Sci 238:169–174Google Scholar
  13. 13.
    Dahlgren SO, Gillberg C (1989) Symptoms in the first two years of life. A preliminary population study of infantile autism. Eur Arch Psychiatry Neurol Sci 238:169–174Google Scholar
  14. 14.
    Gillberg C, Ehlers S, Schaumann H, Jacobsen G, Dahlgren SO, Lindblom R, Bågenholm A, Tjuus T, Blinder B (1990) Autism under age 3 years: A clinical study of 28 cases referred for autistic symptoms in infancy. J Child Psychol Psychiatry 6:921–934Google Scholar
  15. 15.
    Hwang B, Hughes C (2002) The effect of social interactive training on early social communicative skills of children with autism. J Autism Devel Disord 30:331–343Google Scholar
  16. 16.
    Lord C (1995) Follow-up of two-yearolds referred for possible autism. J Child Psychol Psychiatry 36:1–18Google Scholar
  17. 17.
    Lord C, Risi S (2000) Diagnosis of autism spectrum disorders in young children. In: Wetherby AM, Prizant BM (eds) Autism spectrum disorders. A transactional developmental perspective. Paul H Brookes Publishing Co., Baltimore, pp 11–30Google Scholar
  18. 18.
    Lord C, Rutter M, DiLavore PC, Risi S (2002) Autism Diagnostic observation schedule. Manual. Western Psychological ServicesGoogle Scholar
  19. 19.
    Mullen EM (1995) Mullen Scales of Early Learning. American Guidance ServiceGoogle Scholar
  20. 20.
    Osterling J, Dawson G (1994) Early recognition of children with autism: A study of first birthday home videotapes. J Autism Devel Disord 24:247–257Google Scholar
  21. 21.
    Rogers SJ (1996) Brief Report: Early intervention in autism. J Autism Devel Disord 26:243–246Google Scholar
  22. 22.
    Rogers SJ (2001) Diagnosis of autism before the age of 3. In: Glidden LM (ed) International review of research in mental retardation. Academic Press, San Diego, pp 1–31Google Scholar
  23. 23.
    Scambler D, Rogers SJ, Wthner EA (2001) Can the Checklist for Autism in Toddlers differentiate young children with autism from those with developmental delays? J Am Acad Child Adolesc Psychiatry 40:1457–1463Google Scholar
  24. 24.
    Tanguay PE (2000) Pervasive developmental disorders: A 10-year review. J Am Acad Child Adolesc Psychiatry 39:1079–1095Google Scholar
  25. 25.
    Willemsen S, Buitelaar JK, van Engeland H (2001) Is 18 months too early for the CHAT? J Am Acad Child Adolesc Psychiatry 40:737–738Google Scholar
  26. 26.
    Wing L (1997) The autistic spectrum. Lancet 350:1761–1766CrossRefPubMedGoogle Scholar
  27. 27.
    World Health Organisation (1993) Mental disorders. A glossary and guide to their classification in accordance with the 10th revision of the international classification of diseases. World Health Organisation, GenevaGoogle Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • Anegen Trillingsgaard
    • 1
  • Ester Ulsted Sørensen
    • 1
  • Gerda Němec
    • 1
  • Meta Jørgensen
    • 1
  1. 1.Psychiatric Hospital for Children and AdolescentsUniversity Hospital of AarhusRisskovDenmark

Personalised recommendations