Social ABC’s, leading the way in autism research

How a baby says “Ga” could reveal whether or not they are at risk of developing autism, especially if it’s already in their family.

Dr. Jessica Brian and her team at Holland Bloorview’s Autism Research Centre are looking at how predictors for autism could be discovered in babies who have siblings who have already been diagnosed.

Considered a high-risk group, 10 to 25 per cent of kids who have siblings with autism also receive diagnoses. An additional 15 to 20 per cent have difficulties in language learning, social anxiety and other challenges. (These difficulties may overlap with autism but don’t warrant a diagnosis.)

Currently in Canada, most children don’t receive a clinical diagnosis before age three. But Dr. Brian wonders if an opportunity for interventions is being missed, especially if there are signs of autism that can be detected much earlier.

“We have data that shows there are behavioural signs as early as 12 months that predict who goes on to have autism,” she said.

“But most services in Ontario related to autism require a formal diagnosis, so if you don’t get one until age three, it’s hard to get early intervention. The earlier you can identify, the earlier you can make efforts to improve a child’s development.”

The effectiveness of these earlier interventions stems from the nature of brain development.

“We know the younger the brain, the more it can change in response to learning,” said Dr. Brian. “The earlier we can get started with interventions, the larger impact you can have on the child’s development.”

Consider a baby at risk for autism – they may vocalize like any baby, but they are not directing that vocalization to anyone.

“They may not have learned that when they make a vocalization to request something, like their mom’s attention, they have to orient towards her and send the message to her,” said Dr. Brian.

“Babies at risk often have difficulty with that directed communication. If they don’t learn to direct their communication and they continue to vocalize in a non-directed way, it’s much harder for them to learn the relationship between what they do and what happens in the world,” she explained.

In typical development, when a baby says “Ga” and looks at her mom and smiles, she smiles and feels good and it builds a communication relationship.

“But if a baby makes noises that are not directed, it’s harder for people around them to know they are delivering a message to them. And so from very early on these interactions develop in an unusual way,” said Dr. Brian.

To help parents start interventions as soon as autism is suspected, Dr. Brian and her team developed the Social ABC’s – an early intervention program that shows parents strategies to better develop their child’s social communication skills.

We go into the home and teach the parents a few skills and then watch parents play with their child and hone their skills as they go, moment by moment,” said Dr. Brian, one of Social ABC’s co-creators.

Social ABC’s has proved so promising, it caught the attention of the Ontario Ministry of Children and Youth Services.

The Ministry plans on testing four baby and toddler intervention programs for kids at risk of autism (but don’t have a formal diagnosis) over the next three years. Social ABC’s is the only Canadian program, with the other three developed in the US.

For this trial, Dr. Brian will work with a group from Hamilton connected with experts at McMaster University who will deliver Social ABC’s in the Hamilton area, and evaluate its effectiveness in terms of outcomes and cost.

Dr. Brian is excited about Social ABC’s being evaluated on a larger scale.

“For me the goal is to have increased awareness to inform earlier diagnosis and intervention, which would lead to stronger social and communication skills, and improved outcomes overall.”