"At the moment a diagnosis of autism is based on subjective evaluations but a new way of using MRI might be an objective way of spotting the disorder Columbia University researchers report. Autism is a spectrum disorder that includes repetitive behaviors and impairments in language communication and social skills. It is estimated that the condition affects one in  children in the United States according to the U.S. Centers for Disease Control and Prevention. There is a serious unmet need in the autism world where diagnosis is currently done by subjective reports and after the child has missed many developmental milestones said lead researcher Joy Hirsch a professor of functional neuroradiology neuroscience and psychology and director of the Functional MRI Laboratory at Columbia University Medical Center in New York City. It is now possible to develop an objective imaging diagnostic she said. Indeed the researchers found a difference between autistic brains and typical brains in the level of responsiveness in language areas Hirsch noted. What we can measure are signals in the brain in a specific language area that are depressed in autistic children and normal in typical children she said. Although this study was done with schoolaged children and teens the same test can be done with children as young as  months Hirsch noted. We know this technique can be used on young children she said. The report was released in the May  online edition of Radiology in advance of publication in the August print issue. For the study  children with autism and  children without the condition underwent functional MRI fMRI exams. Both groups of children ranged in age from  to  years. While the children were undergoing the fMRI the researchers played recordings of their parents talking to them and watched for brain activity in areas of the brain responsible for hearing and understanding language. The researchers found no differences in the activity in the hearing area of the brain between the two groups. However in the language comprehension area there was significantly more activity among typical children than among children with autism Hirschs group noted. To further test this screening approach another group of  autistic children aged  to  underwent fMRI and the researchers were able to identify  of them as autistic. Dr. Andrew Adesman chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Childrens Medical Center of New York in Lake Success said that although the investigators did indeed find significant differences on neuroimaging between controls and autistic children the clinical utility from a diagnostic standpoint is unclear. There are important limitations to the study Adesman said. For one this study was done in schoolaged children many of whom were actually teenagers so it is impossible to know if these differences in neuroimaging would also be found in younger patients Adesman pointed out. It is during the toddlerpreschool years that autism typically presents and needs to be diagnosed he explained.  The other major limitation of this study is that the investigators did not look at whether these brain differences are specific to children with autism or if they would also be seen for example in children with language delays who are not autistic Adesman said. Hirsch noted the study is preliminary and as such has some limitations. For one it is not known whether this technique can identify autism across the entire spectrum of the disorder. There are questions about how this varies across the severity of autism. Also can we distinguish autism from other forms of developmental delay she asked. These are things that arent known. Further work is needed to refine the test Hirsch added. This is not the diagnostic that you can package and send to all community health centers in the United States. This is an announcement that this can be done she said. This test costs no more than a standard MRI which runs around  Hirsch noted. Another expert Dr. Robert F. LopezAlberola chief of pediatric neurology at the University of Miami Miller School of Medicine said that its nice to have an objective measure but it doesnt really do much. Ultimately he said the diagnosis of autism is a clinical diagnosis. I see this as having more implications for research into the pathophysiology of autism. However if this test could be done in really young children it might help identify autism so that treatment can begin early LopezAlberola suggested. We know the earlier we begin interventions the greater the likelihood of better outcome he said. Although this technique holds promise for identifying infants at risk for autism it still needs to be determined whether the atypical patterns of brain activation are specific to autism said Geraldine Dawson chief science officer for Autism Speaks. It is possible that children who have delayed language but not autism would also show the same pattern. Regardless this research is promising as a method for identifying young children at risk for autism Dawson said. More information For more on autism visit the U.S. National Institute of Neurological Disorders and Stroke http_autism.htm. SOURCES Joy Hirsch Ph.D. professor functional neuroradiology neuroscience and psychology and director Functional MRI Laboratory Columbia University Medical Center New York City Andrew Adesman M.D. chief developmental and behavioral pediatrics Steven and Alexandra Cohen Childrens Medical Center of New York Lake Success N.Y. Robert F. LopezAlberola M.D. associate professor medicine and chief pediatric neurology University of Miami Miller School of Medicine Geraldine Dawson Ph.D. chief science officer Autism Speaks May   Radiology online"