No response to name by infant suggests autism

NEW YORK (Reuters Health) - Infants who don't respond to their name by 1 year of age appear to be more likely to be diagnosed with an autism spectrum disorder or other developmental problem by the age of 2, the results of a new study suggest.

Autism spectrum disorder refers to a group of developmental disabilities, characterized by impaired social, emotional, and communication skills. Many people with autism spectrum disorder also have different ways of learning, paying attention, or reacting to things. The condition typically begins in early childhood and lasts throughout a person's life.

"In current practice, autism is not diagnosed until the third or fourth year of life, although parents tend to have concerns about their child's development much earlier, with 30 percent to 50 percent reporting initial concerns before the first birthday," according to Dr. Aparna S. Nadig, of the University of California Davis M.I.N.D. Institute, Sacramento, and colleagues.

"Earlier identification of autism offers the possibility of early intervention, which holds promise for improving outcomes in children with autism," they write in the Archives of Pediatrics and Adolescent Medicine.

The researchers examined the accuracy of decreased response to name at age 1 year as a possible screening test for autism spectrum disorder and other developmental conditions.

The study included 55 six-month-old and 101 twelve-month-old infants at risk for autism, and 43 six-month-old and 46 twelve-month-old children with no known risk. At-risk infants had an older sibling with autism spectrum disorder.

The team assessed the number of repetitions it took for a child to respond to his or her name. While the child sat playing, a researcher walked behind the child and called his or her name in a normal voice. The name was called again up to two more times if the child did not respond after 3 seconds.

At age 6 months, there was a trend among the infants with no know risk to require a fewer number of calls to respond to their name compared with the at-risk infants. Overall, 82 percent of controls and 66 percent of at-risk infants responded to their name on the first or second call.

Among the 12 month-olds, 86 percent of the at-risk infants responded to their name on the first or second name call, compared with 100 percent in the other group.

Overall, 46 at-risk infants and 25 low-risk infants were followed for up to 24 months.

Of the 12 children who failed to respond to their name at 1 year, 9 were diagnosed with developmental problems at age 2.

Because this test is easy to administer and requires few resources, Nadig's team suggests it could be incorporated into regular pediatric visits.

"If a child fails to orient to name, particularly reliably over time," they advise, "this child has a high likelihood of some type of developmental abnormality and should be referred for more frequent screening, comprehensive assessment, and, if indicated, preventive early intervention."

SOURCE: Archives of Pediatrics and Adolescent Medicine, April 2007.