The Sooner the Better

How do you stop such behavior?
You redirect the child's attention, you engage them in other toys. You also teach them how to pay attention to really important social signals, like people's eyes, people's faces.

So early intervention can affect how a child with autism functions later in life?
It very well can impact how someone functions later. We've just been funded to follow them [the 125 kids in this study and another 150 kids who entered the study later] until they're 8 years old. We have a separate treatment study. If you're not giving these kids real intervention, you see what happens to them. They pretty much stop smiling at people. If you can catch them early and really engage them, their growth curves might look really different.

Does autism begin to develop even sooner than 14 months?
Sometime between 6 and 12 months, there is this period of brain overgrowth. In a baby's brain, there are too many cells, nerve cells. Some of them have to be very systematically pruned away. In the kids with autism, that's not happening properly. The neurobiological underpinnings are probably already there. There's probably something underlying going on, but it hasn't really affected behavior until later. [Heather Cody] Hazlett talks about brain overgrowth not really being detectable until the time of the first birthday. [A 2005 University of North Carolina and Duke University study found that by age 2, kids with autism show a 5 percent enlargement of their brains.]

Could vaccines be a catalyst?
We're going to go back and look at the vaccine histories of these children.

You talk about kids with autism exhibiting irregularities in how they play. For example, they would not pretend to eat with a toy fork. How do we make sure parents whose kids do anything "abnormal" don't automatically suspect autism?
The thing to help parents not be paranoid is this: if there are warning signs for autism, there's more than one. It's not going to just be a fork. No. 1, there have to be multiple signs, and No. 2, the signs have to persist over weeks, months.

How did you diagnose these kids so early?
I had to learn to retrain my eyes when I started to see the 14-month-olds. I thought autism at 14 months was going to look like autism at 36 months, the age at which people normally diagnose it. It's the same flavor--the social system is disrupted, the communication system is disrupted. But it's different in that it's not as pervasively disrupted. What I mean is that at 14 months, you can get kids with autism to give you a beautiful response to peekaboo. But you can't get the child to engage with you around more novel, new activities. At 14 months, you see more flickers of interaction. They were doing some looking at people and smiling.