With increased public awareness of the early signs and recent American Academy of Pediatrics recommendations that all 18- and 24-month-olds be screened for autism spectrum disorders, there is an increasing need for diagnostic assessment of very young children. However, unique challenges exist in applying current diagnostic guidelines for autism spectrum disorders to children under the age of 2 years. In this article, we address challenges related to early detection, diagnosis, and treatment of autism spectrum disorders in this age group. We provide a comprehensive review of findings from recent studies on the early development of children with autism spectrum disorders, summarizing current knowledge on early signs of autism spectrum disorders, the screening properties of early detection tools, and current best practice for diagnostic assessment of autism spectrum disorders before 2 years of age. We also outline principles of effective intervention for children under the age of 2 with suspected/confirmed autism spectrum disorders. It is hoped that ongoing studies will provide an even stronger foundation for evidence-based diagnostic and intervention approaches for this critically important age group.
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May 01 2009
Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants
Lonnie Zwaigenbaum, MD;
Lonnie Zwaigenbaum, MD
aDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Susan Bryson, PhD;
Susan Bryson, PhD
bDepartment of Pediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
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Catherine Lord, PhD;
Catherine Lord, PhD
cDepartment of Clinical and Developmental Psychology, University of Michigan, Ann Arbor, Michigan
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Sally Rogers, PhD;
Sally Rogers, PhD
dDepartment of Psychiatry and Behavioral Sciences, University of California, Davis, California
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Alice Carter, PhD;
Alice Carter, PhD
eDepartment of Psychology, University of Massachusetts, Boston, Massachusetts
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Leslie Carver, PhD;
Leslie Carver, PhD
fDepartment of Psychology, University of California, San Diego, California
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Kasia Chawarska, PhD;
Kasia Chawarska, PhD
gDepartment of Psychology, Yale University, New Haven, Connecticut
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John Constantino, MD;
John Constantino, MD
hDepartment of Psychiatry and Pediatrics, Washington University, St Louis, Missouri
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Geraldine Dawson, PhD;
Geraldine Dawson, PhD
iDepartment of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
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Karen Dobkins, PhD;
Karen Dobkins, PhD
fDepartment of Psychology, University of California, San Diego, California
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Deborah Fein, PhD;
Deborah Fein, PhD
jDepartment of Psychology, University of Connecticut, Storrs, Connecticut
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Jana Iverson, PhD;
Jana Iverson, PhD
kDepartment of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Ami Klin, PhD;
Ami Klin, PhD
gDepartment of Psychology, Yale University, New Haven, Connecticut
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Rebecca Landa, PhD;
Rebecca Landa, PhD
lDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Daniel Messinger, PhD;
Daniel Messinger, PhD
mDepartment of Psychology, University of Miami, Miami, Florida
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Sally Ozonoff, PhD;
Sally Ozonoff, PhD
dDepartment of Psychiatry and Behavioral Sciences, University of California, Davis, California
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Marian Sigman, PhD;
Marian Sigman, PhD
nDepartment of Pediatrics and Psychology, University of California, Los Angeles, California
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Wendy Stone, PhD;
Wendy Stone, PhD
oDepartment of Pediatrics and Psychology, Vanderbilt University, Nashville, Tennessee
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Helen Tager-Flusberg, PhD;
Helen Tager-Flusberg, PhD
pDepartment of Psychology, Boston University, Boston, Massachusetts
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Nurit Yirmiya, PhD
Nurit Yirmiya, PhD
qDepartment of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
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Address correspondence to Lonnie Zwaigenbaum, MD, Autism Research Centre of Alberta, Glenrose Rehabilitation Hospital, 10230–111 Avenue, Edmonton, Alberta, Canada T5G 0B7. E-mail: lonnie.zwaigenbaum@capitalhealth.ca
Pediatrics (2009) 123 (5): 1383–1391.
Article history
Accepted:
September 09 2008
Citation
Lonnie Zwaigenbaum, Susan Bryson, Catherine Lord, Sally Rogers, Alice Carter, Leslie Carver, Kasia Chawarska, John Constantino, Geraldine Dawson, Karen Dobkins, Deborah Fein, Jana Iverson, Ami Klin, Rebecca Landa, Daniel Messinger, Sally Ozonoff, Marian Sigman, Wendy Stone, Helen Tager-Flusberg, Nurit Yirmiya; Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants. Pediatrics May 2009; 123 (5): 1383–1391. 10.1542/peds.2008-1606
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