Simple test may signal autism risk

May 31, 2012

A simple pull-to-sit test of posture control at 6 months may indicate inappropriate neurologic development and warn of autism spectrum disorder in children at high genetic risk. What are the implications for screening and treatment?

A simple pull-to-sit test of posture control at 6 months may indicate inappropriate neurologic development and warn of autism spectrum disorder in children at high genetic risk, according to a presentation at the annual International Meeting for Autism Research in Toronto.

Earlier studies have shown that head lag-failure of the head to align with or stay in front of the spine when an infant is pulled by the arms from a supine to a sitting position-predicts developmental delays in preterm infants and children with cerebral palsy.

This prospective study, the first to examine posture control in children at high risk for autism, demonstrated a significant association between head lag at 6 months and diagnosis of autism spectrum disorder at 36 months. The association occurred less often in low-risk children.

Researchers from the Kennedy Krieger Institute first looked at a group of 40 high-risk babies who had a sibling with autism for correlations between head lag in infancy (tested at 6, 14, and 24 months) and an autism diagnosis at 30 or 36 months. Ninety percent of children diagnosed with autism had shown head lag as infants compared with 54% of children with social or communication delay and 35% of children with neither autism nor social or communication delay.

Investigators then examined a separate sample of 20 high-risk and 21 low-risk infants to explore whether head lag was more prevalent in the high-risk group. They found that 75% of high-risk babies had head lag compared with 33% of low-risk babies.

Head lag is not specific to autism, the researchers note, but it may be an early warning sign that the nervous system is not developing properly in infants at high risk. They say their findings point to the value of early motor assessment in these babies, which may shed light on early manifestations of autism and lead to earlier detection and intervention. Previous research has focused primarily on social development and communication.

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