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World J Clin Pediatr. Dec 9, 2023; 12(5): 273-294
Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.273
Pre-autism: What a paediatrician should know about early diagnosis of autism‎
Mohammed Al-Beltagi
Mohammed Al-Beltagi, Department of Pediatric, Faculty of Medicine, Tanta University‎, Tanta ‎31511‎, Algahrbia, Egypt
Mohammed Al-Beltagi, Department of Pediatric, ‎University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. ‎Sulaiman Al Habib Medical Group, Manama 26671, Manama, Bahrain
Author contributions: Al-Biltagi M collected the data, wrote, and revised the manuscript; The guidelines of the PRISMA 2009 were adopted while writing the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Pediatric, ‎Faculty of Medicine, Tanta University‎, Al Bahr Street, Tanta ‎31511‎, Algahrbia, Egypt. mbelrem@hotmail.com
Received: July 10, 2023
Peer-review started: July 10, 2023
First decision: September 4, 2023
Revised: September 7, 2023
Accepted: September 25, 2023
Article in press: September 25, 2023
Published online: December 9, 2023
Processing time: 150 Days and 12.2 Hours
Abstract

Autism, also known as an autism spectrum disorder, is a complex neurodevelopmental disorder usually diagnosed in the first three years of a child's life. A range of symptoms characterizes it and can be diagnosed at any age, including adolescence and adulthood. However, early diagnosis is crucial for effective management, prognosis, and care. Unfortunately, there are no established fetal, prenatal, or newborn screening programs for autism, making early detection difficult. This review aims to shed light on the early detection of autism prenatally, natally, and early in life, during a stage we call as “pre-autism” when typical symptoms are not yet apparent. Some fetal, neonatal, and infant biomarkers may predict an increased risk of autism in the coming baby. By developing a biomarker array, we can create an objective diagnostic tool to diagnose and rank the severity of autism for each patient. These biomarkers could be genetic, immunological, hormonal, metabolic, amino acids, acute phase reactants, neonatal brainstem function biophysical activity, behavioral profile, body measurements, or radiological markers. However, every biomarker has its accuracy and limitations. Several factors can make early detection of autism a real challenge. To improve early detection, we need to overcome various challenges, such as raising community awareness of early signs of autism, improving access to diagnostic tools, reducing the stigma attached to the diagnosis of autism, and addressing various culturally sensitive concepts related to the disorder.

Keywords: Autism; Pre-autism; Biomarkers; Autism spectrum disorder; Biophysical profile; ‎Neurodevelopment; Antenatal; Neonatal

Core Tip: Pre-autism refers to an early stage of autism during which signs and symptoms may appear and indicate a potential risk of developing autism later in life. Early detection and intervention are crucial to improve outcomes for individuals with autism. Various physical, biochemical, hormonal, and imaging biomarkers are developed to assist prenatal and early-life diagnosis of autism. To improve the early detection of autism, we should try to overcome the various challenges that involve the diagnosis, such as enhancing community awareness, easing the diagnostic tools access, and removing and dealing with the autism-related stigma and culturally sensitive concepts.