Autism prodrome 50 of 89
for their child with the ASD. Should we refer them out for further services such as
prevention and intervention programs for their younger child? What criteria should
lead the field in making such recommendations? And if parents are not concerned
about the development of their younger child, when should we introduce concerns?
These are important issues for researchers and clinicians studying and working with
these families (see Zwaigenbaum et al., 2009; for discussion).
Conclusions
The diagnostic criteria for autistic disorder in the DSM-IV-TR
(American Psychiatric Association, 2000) and the ICD-10 (World Health
Organization, 1992) describe behaviors and impairments in three domains:
qualitative impairments in reciprocal social interaction, impairments in
communication and restricted, repetitive, and stereotyped patterns of behavior,
interests, and activities. As can be seen in the current review, the attempt to
describe the prodrome involved, and yielded, findings pertaining to
antecedents in these three domains. The prodromal behavioral indicators
include delays and impairments in early social-communication and social
relating behaviors, as well as the earliest emerging signs of rigid and
stereotyped behaviors and interests. Many of these indicators have been
identified and confirmed in the home video, populations screening and high
risk sibling studies reviewed above. However, although we have a list of early
markers and risk factors, we still do not have an in-depth understanding or a
description of one or more developmental trajectories for the prodrome of
ASDs and for the various different ASDs. Some ASDs are recognizable
earlier (i.e., ‘core’ Autistic Disorder (DSM-IV) or Childhood Autism (ICD-
10)), especially when accompanied by a delay in language milestones and