Autism is a mysterious and complex disorder, the causes of which are, as yet, unknown. A new study published recently in the journal Nature may have found clues for early diagnosis which could allow doctors to halt or slow down progress of the condition.

Scientists discovered that there were differences in the level of eye contact made by babies who went on to develop autism compared to those who did not. Eye-tracking technology was used to monitor infants from birth, and results indicated that the differences began to occur between the ages of 2 and 6 months. Typically, by the age of around 9 months, most babies have begun to make eye contact very noticeably and continue to display such interactive behavior until they reach toddlerhood, but affected babies were shown to make less eye contact during the same age range, with the less social behavior becoming more apparent as the autistic children grew up.

The study was conducted by a team at the Marcus Autism Center and Emory University, and was led by Warren R. Jones, director of research at the autism center, and co-author Ami Klin. Two different groups of infants took part: one was a low-risk group with no evidence of autism within their immediate family, and the other was a high-risk group where participants had autistic siblings, which made them 20 times more likely to develop the disorder.

"We’re measuring what babies see, but more importantly we’re measuring what they don’t see,” Dr. Jones said. "Kids whose eye fixation falls off most rapidly are the ones who later on are the most socially disabled and show the most symptoms. ”

The results indicated that the level of eye contact made during infancy directly correlated with the severity of symptoms occurring in later life, with those babies displaying little or no interest in faces going on to develop the worst cases of autism. “These are the earliest known signs of social disability, and they are associated with outcome and with symptom severity, " said Dr. Jones. " Our ultimate goal is to translate this discovery into a tool for early identification” of children with autism."

Dr. Jones was quick to provide reassurances for parents who perceive that their children are not making continual eye contact, as the scientific markers identifying affected babies would only be apparent using the special eye-tracking equipment used in the study. “We don’t want to create concern in parents that if a child isn’t looking them in the eyes all the time, it’s a problem,” he said. “It’s not. Children are looking all over the place."

In total, 110 children were monitored from the age of 2 months until they were 2 years old. They were exposed to stimuli including videos of caring and friendly female adults, while the eye-tracking equipment recorded their responses to faces, toys and inanimate objects.

The researchers noted that children who developed autism were more preoccupied with objects rather than people beyond the age of 12 months, while non-autistic children typically lost interest and became more socially interactive. Dr. Dawson explained that this how babies usually learn about “facial expressions and language and gesture. If the baby who’s developing autism is paying attention to objects, they’re really losing out on those opportunities.”

The children were then assessed against the autistic spectrum at age 3, when it was determined that 11 out of 36 boys had developed autism. Only two of the girls within the groups went on to become autistic so the results were based solely on the male participants. Though the study was relatively small, the findings were significant because they were measured over a prolonged period, rather than merely providing a ‘snapshot’ at any one time.

Consequently, the evidence has been well-received by the authors’ peers, and autism experts, such as Dr. Geraldine Dawson, director of the Center for Autism Diagnosis and Treatment at Duke University, were very encouraged by the outcome. “It’s well done and very important,” said Dr. Dawson. “Early on these babies look quite normal; this really gives us a clue to brain development.”

Dr. Dawson said that the results indicated abnormalities in the higher cortical regions of the brain, which are concerned with intention. Initially, it is thought that children stare at faces as part of a reflex action controlled by lower cortical regions, but as they mature they begin to choose what they focus their attention on.

“As the brain develops, babies begin to use these behaviors in a more intentional way. They can look at what they want to look at," she said. "We think that these higher cortical regions are the ones that are not working the same” as in typical children."

Dr. John N. Constantino, a child psychiatrist and pediatrician at Washington University in St. Louis, suggested that the results could be quite profound, indicating that autistic children see the world in a totally different way:

“Babies who develop autism are for the most part doing an awful lot of things right for the first few months,” he said." Perhaps the genes that drive autism begin to derail typical development after that, so that “what you are looking at moment by moment, day by day, second by second, is completely different from what other children are looking at, and the cumulative experience is what sends you off into the trajectory of autism.”

Symptoms of autism normally become apparent between the ages of 3 and five, though advice from the American Academy of Pediatrics suggests that screening should take place earlier, between 18 and 24 months. According to figures released by the Centers for Disease Control and Prevention, cases of autism are on the increase. Between 2002 and 2008, diagnosed cases had increased from one child in 150 to one in 88, but the reasons for this increase have not yet been determined. Scientists postulate that greater awareness of symptoms has led to more cases being diagnosed, and they also suggest that there is a link between autism and older male parents.

It is interesting to note that the differences observed in the subjects of the recent study were not apparent at birth, so the study does not rule out exposure to external factors encountered post-natally which could potentially be responsible for triggering the condition in susceptible infants. One of the factors which has been widely speculated to cause autism is the Measles, Mumps and Rubella vaccine (MMR). A recent court ruling at the vaccine court’s Autism Omnibus Proceedings has now verified that the vaccine has been implicated in certain cases of autism, though news of this appeared to fly beneath the radar of the mainstream media.

Part of the court ruling was not released to the public, but it was confirmed that the MMR vaccine had indeed caused autism in 10 year old Ryan Mojabi, and he was awarded millions of dollars in compensation. Ryan suffered an encephalopathy after his MMR vaccination on December 19, 2003, which subsequently led to him developing asthma and autism spectrum disorder (ASD). The U.S. Department of Health and Human Services issued the following statement regarding the case:

“Ryan suffered a Table injury under the Vaccine Act — namely, an encephalitis within five to fifteen days following receipt (ofMMR). This case is appropriate for compensation.”

Encephalopathy is a known complication after vaccine administration, and is termed a "table injury". Ryan’s parents said that the MMR caused his encephalopathy which manifested as “neuroimmunologically mediated dysfunctions in the form of asthma and ASD.” They took his case to various courts in an attempt to seek compensation, and eventually secured a hearing at the vaccine court, where, in a landmark ruling, the government confirmed that Ryan’s symptoms had been caused directly by his MMR vaccination.

Ryan’s case may now open the floodgates for other affected children to receive compensation for injuries sustained after vaccination. During the same month, the vaccine court also ruled that Emily Moller was entitled to a large settlement payment after experiencing severe reactions to multiple vaccines, including the MMR. Emily also went on to develop autism and other associated conditions, which seems to provide irrefutable evidence that vaccines are implicated, at least in part, to many cases of ASD, and appears to confirm research put forward by Dr. Andrew Wakefield over 15 years ago.

Dr. Wakefield put his career and reputation on the line back in the 1990s when he suggested that the MMR and other vaccines were harmful, and remains convinced that his research was sound:

“There can be very little doubt that vaccines can and do cause autism,” Dr. Wakefield recently stated from his home in Austin, Texas. “In these children, the evidence for an adverse reaction involving brain injury following the MMR that progresses to an autism diagnosis is compelling. It’s now a question of the body count. The parents’ story was right all along. Governments must stop playing with words while children continue to be damaged. My hope is that recognition of the intestinal disease in these children will lead to the relief of their suffering. This is long, long overdue.”

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