Early Identification of Infants at Risk for ASD using Head Circumference and the Head Tilt Reflex

Background:

Autism Spectrum Disorder is a neurobiological disorder that occurs one in 150 children.  Children have a triad of well known features including severe speech and language dysfunction, repetitive stereopathies and atypical social interactions. Early identification results in significant improvement in development and reduction in behavioral symptoms.  Retrospective studies show that head circumferece (HC) in children with ASD accelerates between 6 and 12 months. Teitlebaum and associates have shown in a small study that children with ASD did not acquire head tilt reactions appropriately. This is a normative study in typical developing infants to assess the reliability of these two measures to identify infants at risk for ASD.

Objectives: This study focused on two possible risk factors which indicate vulnerability for ASD. They were abruptly changed from the 50^th percentile to above 75^th percentile and head tilt reflex.

Methods: 366 infants were enrolled in the study and HC was measured and head tilt responses were completed at 4, 6 and 9 months of age.  Children had a neurodevelopmental evaluation if head circumference abruptly changed from the 50^th percentile to above 75^th percentile or if head tilt response was not established by 9 months. 

Results: Sixteen infants had neurodevelopmental evaluations because of atypical head tilt reaction or accelerated head growth.  Three children were determined “at risk” for ASD with developmental delay.  All three infants were referred for EI services and will be followed to see if the diagnosis of ASD is confirmed.    

Conclusions: Risk factors are a quick and efficient mechanism to assist PCP in identifying children who are at risk for ASD and other neurodevelopmental disorders. It appears to be an effective mechanism to facilitate early identification and treatment of children at risk for ASD and neurodevelopmental disorders by

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