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efforts at early identification and the possibility to develop and test
interventions that may lessen the neurodevelopmental perturbations that lead
to the ASD phenotype; shifting the trajectory of individuals and improving
outcomes for children and their families. Whilst progress in science and
clinical practice can be frustratingly slow; our understanding of the early
emerging ASD phenotype has undergone a revolution in the past 20 years. The
challenge for the next decade is to improve our understanding of the
underlying biological and environmental influences that lead to the ASD
phenotype; and to identify prodromal signs that will help mark out infants at
risk before the onset of the disorder.
• Several novel lines of investigation have been employed, including
retrospective coding of home videos, prospective population screening and
‘high risk’ sibling studies.
• Other methods include investigation of pre- and peri-natal, brain
developmental and other biological factors.
• Whilst no single prodromal sign is expected to be present in all cases, a picture
is emerging of indicative prodromal signs in infancy.
• The most common early behavioral signs noticeable towards the end of the
first year of include social communication abnormalities but also possibly
regression, attention, and motor signs.
• There is great interest in several apparent atypicalities in brain structure,
connectivity and function, although it remains to be determined how specific
these will be to ASD.