• Psychologists are working from many angles to enhance the lives of people with autism

Approximately, 1 in 59 children are diagnosed with autism in the United States and each year more than 60,000 teenagers with autism age out of the school system and launch into adulthood. Though the behavioral symptoms of autism start to emerge at about 18 months of age, children’s median age at diagnosis remains stubbornly stuck at around ages 4 to 5. Even after diagnosis, many children don’t receive the services they need because of long waitlists for treatment or inadequate insurance. And the service system for adults with autism is particularly sparse, with research showing that people with autism often struggle to live independently, do not receive much-needed services and are disproportionately unemployed.

Autism in Infancy

One focus is on providing extra scaffolding and support for children with autism when they are very young. Infants who develop autism show similar patterns of unusual brain growth, particularly the hyperexpansion of cortical surface area between 6 and 12 months of age, and an overgrowth of brain volume and disruption in functional connectivity between 12 and 24 months of age, according to a review co-authored by Joseph Piven, MD, a psychiatrist and the director of the University of North Carolina’s (UNC) Carolina Institute for Developmental Disabilities (Molecular Psychiatry, Vol. 22, No. 10, 2017). These observations were made in younger siblings of children with autism—who are at high risk of developing autism themselves—as part of an NIH-funded multisite research project. Researchers like Piven think that the brain differences found in these high-risk children will also be found in children who are the first in

their families with a diagnosis. If the results do generalize across the two groups, they could lead to brain imaging–based autism diagnoses before symptoms emerge. Earlier diagnosis, in turn, could lead to more effective interventions. “Infancy is a period where the brain is maximally malleable,” Piven says. To intervene that early, though, researchers need to find biomarkers for autism that can be reliably detected in the first year of life.

Gaze-tracking technology might be another avenue for early diagnosis, according to Klin.

In 2013, Klin and neuroscientist Warren Jones, PhD, found that infants who would later be diagnosed with autism showed a decline in time spent looking at other people’s eyes beginning after 2 months of age (Nature, Vol. 504, No. 7480, 2013). The researchers are now testing a device designed to use eye-gaze information to capture autism risk in babies and young toddlers. Because there aren’t any clinical diagnostic tests for autism before 18 months of age, there is little research on interventions in infants and toddlers. But there is good reason to think that malleable infant brains would take well to treatment.


Pappas, S. (2020). Helping People with Autism Reach their Full Potential. Vol. 52. No. 5.

Pg. 26. American Psychological Association.