Signes précoces d'autisme: D'où vient-on? Où va-t-on?

Autism is a clinical syndrome that has contributed to the foundation of child psychiatry following Kanner's characteristic description. Yet, 60 years later, it remains a topic of unresolved issues and of many controversies, including the reliable age for early diagnostic. In this paper, we explore this issue by distinguishing: available data from epidemiologic studies in general population samples and at-risk samples; the view from parents regarding early diagnosis as well as the way they receive it in clinical practice in France; what was found in studies on early infant-caregiver interaction in home movies. We will show that a delay in developmental milestones and impairments in early social interaction or communication during the first 18 months are not sufficient to predict a later diagnosis of autism. This has led to a change of paradigm in the recent studies that consider now the quality of early interaction in terms of synchrony and reciprocity as well as emotional engagement. Lastly, we point recent efforts made in France to change clinical practice and offer an earlier diagnosis formulation to parents.