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Received 14 October 2009;
Abstract
The current study reviewed all prior studies conducted on family home movies of infants who would be later diagnosed with autism spectrum disorder (ASD). Out of 41 original reports found since 1975, we retained 18 studies (317 films, maximum), sorted according to their methodological design using a quality grid. In the first 2 years of life, signs that differentiated children with ASD from children with developmental delays were as follows: less of a response to their name, less looking at others, lower eye contact quality and quantity, less positive facial expression and intersubjective behaviors (e.g., showing shared attention). Studies focusing on regression confirmed the clinical validity of the phenomena. We conclude that findings from home movies studies along with prospective studies have created the bases for identification of infants and toddlers at risk of developing ASD before the 18–24-month period, despite early diagnosis of autism remains a complex challenge.
Keywords: Autism; Pervasive Developmental Disorder; Home movies; Early identification; Regression
Article Outline
- 1. Introduction
- 2. Methods
- 3. Results
- 3.1. General comments
- 3.2. Early signs of ASD during the first 2 years of life
- 3.3. Is autistic regression or late-onset autism (LOA) a valid concept?
- 3.4. Developmental course in early-onset autism
- 4. Discussion
- 4.1. Comparing findings from home movie studies with those from prospective studies
- 4.2. What are the early warning signs for ASD that can be used in an early screening?
- 4.3. Developmental issues
- 5. Conclusions
- Acknowledgements
- References
Fig. 1. Early signs of autism according to age and main developmental domain from home movie studies. Signs that are more specific to autism (compared to children with developmental delays) appear in bold. N indicates the number of studies reporting the corresponding item. 1Significant in the 6–12-month period in 1 study; 2significant in the last months of the first year in 3 studies; 3significant in the 0–6-month period in 1 study; 4significant in the 6–12-month period in 2 studies; 5significant in the last months of the first year in 2 studies; 6significant in the 6–12-month period in 1 study.
Main methodological characteristics of home movie studies on infants who later exhibit ASD (1975–2008).
JA = joint attention; aut. signs = autistic signs; dev. skills = developmental skills; DD = developmental delay; TD = typical development; EOA = early onset autism; LOA = late-onset autism; AD = autism disorder; ASD = autism spectrum disorder; PDDNOS = pervasive developmental disorder not otherwise specified; D3 = DSMIII; D3R = DSMIIIR; D4 = DSMIV; HF = high-functioning; MR = mental retardation; Qual. score = quality score; N.A. = not appropriate.
a Indicating intermediate age, meaning that authors realized sub-analysis for each intermediate age range.b Unless specific indication (DD), control were normally developing children.
c Mean IQ, or repartition of the autistic sample according to IQ, or IQ range/when indicated, mean IQ in DD sample.
d Studies excluded from the review of early signs of autism and used in other analyses.
Early signs of PDD in home movie studies (N = 18): significant differences for infants with ASD compared with typically developing children.
JA = joint attention; EOA/LOA = children with early-onset/late-onset autism; DD = children with developmental delay; TD = typically developing children.
Early screening for risk of autism according to prospective and home movie studies.
ISB: intersubjective behaviors; RJA: response to joint attention.
Specificity in autistic/delayed comparison: (–) not specific in home movie studies; (+/−) partially specific in home movie studies; (++) specific in home movie studies; (+++) specific in home movies + prospective studies.
Sensitivity: rate of studies that found significance for this item; S = sensitivity as calculated in one study. Most pertinent items (as regards sensitivity, reproducibility and specificity) appear in bold.
Corresponding author at: Department of Child and Adolescent Psychiatry, Groupe Hospitalier Pitié-Salpétrière, APHP, Université Pierre et Marie Curie, 47 bd de l’Hôpital, 75013 Paris, France. Tel.: +33 1 42 16 23 51; fax: +33 1 42 16 23 53.1 Tel.: +33 06 79 09 22 18; fax: +33 01 44 27 44 38.
2 Tel.: +39 050 886111; fax: +39 050 886202.



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