Autism prodrome 51 of 89
intellectual disability) and others later on (i.e., Asperger’s Syndrome with
normal or even advanced language development and intelligence).
Furthermore, some cases of ASDs involve genetic (some familial;
some sporadic) and environmental contributions (e.g. peri-natal) whereas
others may not, and the transaction among genetics and environment may vary
tremendously even among individuals with the same ASD diagnosis. Although
it is clear that these causative factors affect brain development, organisation
and function in a way that leads to the ASD phenotype; we have not yet
identified prodromal brain markers that securely signpost the later emergence
of full blown disorder and the extent to which any of these markers will be
specific to autism, as opposed to a range of other neurodevelopmental
outcomes is not known. Similarly, behavioral phenomena such as regression,
epilepsy and developmental delays, amongst others, also vary among
individuals with ASDs. Taken together, these many variations may make the
search for a unifying prodrome extremely difficult or even impossible. The
heterogeneity of causation and manifestation of ASDs makes the search a
unifying prodrome perhaps a lost cause both for science and for clinical
practice.
As we combine our efforts and study cohorts of children at risk for
ASDs taking into account genetic and environmental factors, as well as
specific behavioral profiles of the children, we hope to find out more about the
aetiology of ASDs. In future this may allow us to develop a different, more
elaborated and more empirically-based nosological systems than those
currently employed in the diagnostic manuals and be able to better delineate
the prodromes of the various ASDs. This holds out the promise of improving