By Renée Marchant, Psy.D.
Pediatric Neuropsychologist
Early diagnosis is a catalyst for propelling children on positive trajectories. If a family and child identify and focus on areas of growth earlier rather than later, there is more time and more possibility of change and improvement. This tenant is particularly critical for diagnosing ASD in toddlerhood and early childhood.
Here are critical facts about the diagnosis of ASD in early childhood and the positive impact of early diagnosis on youngsters as they age into adulthood.
- Most children with ASD are not diagnosed until approximately 4 years-old, yet ASD can be reliably identified by the age of 2. There is also expanding research on early identification of infants who may be at risk for ASD. Early detection is possible.
- Genes play an important role in ASD. A child’s odds of having an ASD diagnosis increases if he/she has a sibling or parent with ASD, attention deficit hyperactivity disorder (ADHD), intellectual disability, schizophrenia, depression, bipolar disorder or anxiety. Family medical history is an important factor for families considering a diagnostic evaluation.
- Co-occurring disorders (such as anxiety and depression) are more likely in individuals with ASD than the general population. Identifying emotion regulation issues in early childhood is thus essential.
- Neuroplasticity matters. Because ASD is a neurodevelopmental disorder, early treatment improves neuroplastic brain functioning and subsequent behavior. As a child develops, his/her brain becomes less plastic.
- Interventions geared at a child’s “first relationships” with their caregivers may exert a strong positive effect on the developmental trajectories of toddlers at high-risk of ASD and also have a positive impact on a child’s social skills with peers as they age.
- Research indicates that parent-child interactions in early childhood predict long-term gains in language skills into adulthood for individuals with diagnoses of ASD. Acquiring communicative, pragmatic and useful language by kindergarten has also been identified as a strong predictor of adaptive or functional “real life” skills, which are needed to navigate the environment in adolescence and adulthood.
- Social skills instruction in a child’s early years increases competency with peers in school. This social competency is associated with greater adaptive independence in children with ASD.
- Working with a “diagnostic navigator” early in your child’s life improves outcomes. Research clearly indicates that social support is vital to relieve stress associated with caregiving for a child with ASD and that a positive parent–professional relationship is helpful in alleviating family stress.
If you suspect your child has or is at higher risk for ASD and you are looking for a “diagnostic navigator” for your child, consider an evaluation with NESCA. While early diagnosis of ASD can make a positive impact on a child’s trajectory, obtaining the accurate diagnosis and recommendations for interventions at any age is critical.
References:
Elder JH, Kreider CM, Brasher SN, Ansell M. Clinical impact of early diagnosis of autism on the prognosis and parent-child relationships. Psychol Res Behav Manag. 2017;10:283-292. Published 2017 Aug 24. doi:10.2147/PRBM.S117499.
Dawson G, Jones EJ, Merkle K, Venema K, Lowy R, Faja S, Kamara D, Murias M, Greenson J, Winter J, Smith M, Rogers SJ, Webb SJ. Early behavioral intervention is associated with normalized brain activity in young children with autism. J Am Acad Child Adolesc Psychiatry. 2012 Nov;51(11):1150-9. doi: 10.1016/j.jaac.2012.08.018. PMID: 23101741; PMCID: PMC3607427.
Jokiranta-Olkoniemi E, Cheslack-Postava K, Sucksdorff D, Suominen A, Gyllenberg D, Chudal R, Leivonen S, Gissler M, Brown AS, Sourander A. Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders. JAMA Psychiatry. 2016 Jun 1;73(6):622-9. doi: 10.1001/jamapsychiatry.2016.0495. PMID: 27145529.
Kasari C, Siller M, Huynh LN, Shih W, Swanson M, Hellemann GS, Sugar CA. Randomized controlled trial of parental responsiveness intervention for toddlers at high risk for autism. Infant Behav Dev. 2014 Nov;37(4):711-21. doi: 10.1016/j.infbeh.2014.08.007. Epub 2014 Sep 26. PMID: 25260191; PMCID: PMC4355997.
Mayo, J., Chlebowski, C., Fein, D.A. et al. Age of First Words Predicts Cognitive Ability and Adaptive Skills in Children with ASD. J Autism Dev Disord 43, 253–264 (2013). https://doi.org/10.1007/s10803-012-1558-0.
Siller, M., Swanson, M., Gerber, A., Hutman, T., & Sigman, M. (2014). A parent-mediated intervention that targets responsive parental behaviors increases attachment behaviors in children with ASD: results from a randomized clinical trial. Journal of Autism and Developmental Disorders, 44(7), 1720-1732.
Xie S, Karlsson H, Dalman C, Widman L, Rai D, Gardner RM, Magnusson C, Schendel DE, Newschaffer CJ, Lee BK. Family History of Mental and Neurological Disorders and Risk of Autism. JAMA Netw Open. 2019 Mar 1;2(3):e190154. doi: 10.1001/jamanetworkopen.2019.0154. PMID: 30821823; PMCID: PMC6484646.
About the Author:
complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.
Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.
Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).
Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.
To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.
Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.











M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s 


and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.
Remove Distractions – Take a moment to sit down at your child’s workstation and note any potential distractions. Some will jump right out, such as a TV or box of enticing toys within their line of sight, but some may be less obvious. Are they near a window facing a busy street or a dog park? Is there a substantial amount of visual clutter around their desk, such as busy posters or a family photo collage? Is their desk covered in mail, knickknacks, or arts and crafts supplies? If removing items is not an option, consider creating a physical barrier between your child and any environmental distractions by using a desktop study carrel/shield. Taking these distractions away will help a student to focus their energy on attending to school, as opposed to ignoring it and resisting distractions.




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