Language and social symptoms improve with age in some autistic toddlers, but not in others, and such outcome differences are not clearly predictable from clinical scores alone. This study aimed to identify early-age brain alterations in autism that are prognostic of future language ability. Analyzing 372 longitudinal structural MRI scans from 166 autistic and 109 typical toddlers, researchers found that autistic toddlers showed differences in temporal and fusiform regions (larger/thicker), inferior frontal lobe and midline structures (smaller/thinner), callosal subregion volume (larger), and cerebellum (smaller). These brain alterations improved language outcome prediction accuracy at 6-month follow-up, exceeding the accuracy of intake clinical and demographic variables alone. Temporal, fusiform, and inferior frontal alterations correlated with autism symptom severity and cognitive impairments.

Kuaikuai Duan, Lisa Eyler, Karen Pierce, Michael V. Lombardo, Michael Datko, Donald J. Hagler, Vani Taluja, Javad Zahiri, Kathleen Campbell, Cynthia Carter Barnes, Steven Arias, Srinivasa Nalabolu, Jaden Troxel, Peng Ji, Eric Courchesne