During the month of April 2021, we will dedicate all topics to Autism Spectrum Disorders. Starting with....
How Pediatricians Screen for Autism
All children should receive a formal Autism Spectrum Disorder screening at their 18 and 24 month well-child appointments and results should be explained to parents.
Experts remain divided on whether autism can be diagnosed before age 3. The American Academy of Pediatrics recommends screening for autism starting at 18 months. However, the U.S. Preventive Services Task Force — a government panel that makes recommendations about preventive medicine — has said there is insufficient evidence to recommend universal screening before 3.
A study by Pierce K. et al. published in JAMA Pediatr. (Epub ahead of print (2019) PubMed)
suggests that early screening and diagnosis may benefit some proportion of children: It indicates that some toddlers are likely to have clear enough signs of autism to warrant a diagnosis before 2 years of age,
The American Academy of Pediatrics (AAP) recommends screening all children for ASD at the 18 and 24-month well-child visits in addition to regular routine developmental surveillance and screening. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. We know that intervention prior to 3 years of age can have lifelong benefits. For screening to be effective, it must be applied to all children – not only those with symptoms.
There are multiple different tools your provider can choose to screen for ASD. While the AAP does not endorse any specific ASD screening tool over another, here are some your child's provider may use:
Ages and Stages Questionnaires SE-2 (ASQ-SE2)
Pervasive Developmental Disorders Screening Test-II (PDDST-II)
Communication and Symbolic Behavior Scales (CSBS)
Modified Checklist for Autism in Toddlers – Revised with follow-up (M-CHAT-R/F)
The M-CHAT-R/F the most common screening tool used in pediatric offices.
It is a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening tool, pediatricians will be prompted to start conversations about language delays, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.
But, screening isn't diagnosing!
If your child has a positive screen for an Autism spectrum disorder, it doesn't mean he or she will be diagnosed on the spectrum.
If your child screens normally but you continue to worry about ASD, don't be shy. Screening tests are just that—screening—and don't identify all children with ASD.
The rate of success for the M-CHAT -R/F, for example, is not 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance.
Additional topics coming up:
Follow us @champspediatricskihei for more