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Autism is a complex developmental disability which, until now, researchers thought began during the first three years of life. So far there is much debate over risk factors and contributory factors involved in developing autism, with diet, the body’s ability to process vitamins and vaccines all linked to autism, but as yet there is not enough solid evidence to draw a straight line between them. The strongest case for a contributory factor is genes, as demonstrated most clearly by twin studies that have shown that identical twins are much more likely to both develop autism than non-identical twins. Now, however, scientists have found evidence that autism may well start to form in the womb. If this is true, how can it help to shine new light on the disease? And what problems may it cause?

Published in the New England Journal of Medicine new research suggests that changes in the developing brain before birth may cause symptoms of autism spectrum disorders (ASD). The researchers from the University of California, San Diego and the Allen Institute for Brain Sciences in Seattle, analaysed post-mortem brain tissue of children with and without autism, all aged between two and fifteen. Previous studies have tended to use adults, which may explain why the results are so breathtakingly new. Autism involves early brain overgrowth and dysfunction in the prefrontal cortex. As seen in a previous analysis an excess of neurons in the prefrontal cortex in children with autism signaled a disturbance in prenatal development. The researchers hoped to investigate this further by showing that those brain defects definitely occurred pre-birth.

Having examined the brain tissue of the deceased, researchers found clusters of disorganized cells in the regions of the brain that are pivotal for regulating social functioning, emotions and language, activities that are problematic for autism sufferers. Crucially, this cluster of cells was found in ten of the eleven children with autism, but only in one of the children who did not have the disease. It is believed that these defective cells formulate in the second or third trimester of pregnancy. By using genetic markers the researchers were able to study in detail how the cortex formed layers and connections. If these results are true then it would also explain how some children with autism show signs of improvement if treated early enough. With these clusters of cells spread about brain areas it would be possible, due to the plasticity (adaptiveness) of the brain, to compensate and rewire itself whilst the child is at a young age.

This new insight could be the key to unlocking the exact risk factors behind autism and also encourage early intervention and treatment as soon as the disorder is detected. It also serves to eliminate other theories as to risk factors, such as the aforementioned vaccination, as if autism forms during pregnancy then childhood vaccinations cannot possibly be a cause, and research can be realigned accordingly. However, these are but preliminary results and need to be replicated, ideally with a larger sample group. What cannot be denied though is that the results are promising and add credence to a belief that autism develops pre-birth. Finally there is a small piece of evidence that supports the theory, and the fact that the cell clusters are located in the most fundamental areas of brain development certainly suggest that researchers are on the right track.

Carol Povey, director of the National Autistic Society Centre for Autism, said the study shed light on a complex and often misunderstood disability.”Better understanding of the early brain development of children with autism could help us find new and more effective ways to support the estimated 700,000 people living with the condition across the UK,” she said. “Autism can have a profound and devastating impact but the right support can make a huge difference.” However, for all the good this new research can do, there is a possibility that it can be construed into a reason for malpractice. If autism does begin in the womb and can be detected it would give parents a heads up of what to expect and to better plan for the future – but it also opens a new door to them. For some, having a child with autism would be overwhelming, and they would start to think about having the foetus aborted. In countries with a one child policy, knowing your child would be disabled presents a stark, unjust reality. Where culture dictates that the young look after the old, not just for financial or traditional reasons but because there is no other option, a child with autism may risk the lives of all the family. In other countries it would be seen as bringing disrespect to the family, and in India or China where the aborting of girl foetuses is commonplace, then this research just provides another excuse for the ending of a life before it has even begun. Although pinpointing the starting point of autism will open up new possibilities at studying the contributing factors involved in its development, we must be careful that it does not become a double-edged sword.