It is estimated that autism spectrum disorders (ASD) affects 1 in 68 children in the United States. Evidence from studies of infants at high risk for ASD reveals that although the age of onset of ASD clinical features is variable, subtle signs can already be detected in the first year of life. These include brain volume changes in children with ASD, as well as behavioral changes in social visual and vocal engagement. Despite these findings, detecting autism reliably in young children is difficult and the average age of diagnosis for ASD remains at approximately four years of age. In addition, studies have established that children from racial and ethnic minority groups are often diagnosed and engaged in treatment at later ages. Delays in diagnosis have profound cascading effects, since early intervention has been demonstrated to improve cognitive and behavioral outcomes for young children with ASD.

Since early detection and treatment are two of the most important factors optimizing outcomes, universal screening is one approach to reducing the age of diagnosis and improving outcomes. Well-validated instruments exist to screen toddlers for ASD between 18-24 months of age, and research in high-risk sibling populations has shown that screening at age 18-24 months is a successful strategy to detect risk for ASD. This FOA is in response to strong evidence that many infants at risk for ASD show differences in the way social attention and early forms of communication develop over the first year of life. These early signs correspond with other research findings that genetic and environmental risks for ASD appear to act before birth to alter very early stages of brain development. This FOA encourages exploratory applications to develop new methods for ASD risk assessment, which may have the potential to be translated into objective, efficient, cost-effective screening tools for use in infants (0-12 months of age) that are deployable in the general population.

Areas of research interest and opportunity include, but are not limited to, the following:

Applicants are strongly encouraged to consult with NIH staff when developing plans for an application (see Scientific/Research Contacts, Section VII). This early contact will provide an opportunity to clarify NIH policies and guidelines, and help to identify whether the proposed project is consistent with NIH program priorities.