While scientists are still trying to unravel the complex genetic and environmental causes of autism, one thing is clear: Getting a diagnosis can often be a lengthy and frustrating process. But simple home videos could make diagnosing autism easier, resulting in earlier treatment, new research suggests.
Researchers at Stanford University and Harvard University wanted to determine whether a common autism clinical evaluation tool could be used looking at home videos of children, explains senior author Dennis Wall, Ph.D, associate professor of pediatrics in systems medicine at Stanford University School of Medicine.
“Autism is diagnosed by observing behaviors, and getting a diagnosis can sometimes take a year or more,” he says. “We thought home videos could help identify some of the core features of autism while kids are in a natural environment, not being evaluated in a doctor’s office, which can be a difficult environment for anyone.”
The scientists gathered 100 short YouTube videos showing children ages one-to-15 years at play for the study published Wednesday in the journal PLOS ONE. Forty-five of the videos were tagged by their creators with words like “autism,” “autism spectrum disorder, “Asperger’s,” or with behaviors such as hand-flapping. These videos were then classified by the scientists as showing children with autism. The remaining 55 videos were classified by the scientists as not showing autism spectrum disorder.
A group of undergraduate students was trained to rate the children’s behavior using a scale based on the Autism Diagnostic Observation Schedule, or ADOS, a tool consisting of a series of tasks involving social interaction between the subject and a trained examiner. Since the videos were pre-recorded, raters involved in the study could only use questions from the scoring system relating to eye contact, repetitive behaviors, whether a child picked up on social cues from others in the video, and whether they played with toys appropriately.
Using this system, the study’s undergraduate raters accurately classified children as autistic or non-autistic 97 percent of the time, the researchers found. “It was really amazing to achieve this with non-clinical personnel,” Wall says. “We could use a system like this to triage children, so they can get the attention they need as quickly as possible.”
In most cases, autism can be diagnosed in children as young as 2. The problem, though, is that most kids aren’t diagnosed until age 4 or older. “Anything that we can do to get to an early diagnosis and earlier intervention is only going to benefit a child,” says Stanford behavioral and developmental psychologist Kari Berquist, Ph.D, who was not involved in the study.
One of the issues in later diagnosis is that some parents are told to “watch and wait,” resulting in children not getting full autism evaluations by specialists until they are older. “It can be incredibly frustrating for parents, so a video could be another tool to use, and one that can be easily shared, though it won’t replace traditional techniques of diagnosis,” Berquist says.
Although there is no doubt that diagnosing autism can be a lengthy process “. . . there is a reason for that,” says pediatric neurologist Dr. Max Wiznitzer of Rainbow Babies & Children’s Hospital in Cleveland, Ohio. “Autism is complex, and getting the diagnosis right is a complex process. This study is trying to oversimplify everything.”
Making sure a diagnosis is accurate is as important as early intervention. “I saw a boy recently whose well-meaning teacher was convinced he had Asperger syndrome,” Wiznitzer says. “The child didn’t have Asperger’s, he was depressed.”