Physicians Conflicted Over Wisdom of Early Autism Screening
Currently, there is not enough data to ascertain with certainty whether 18 to 30 month-old children should be screened for autism if no symptoms of the disorder have emerged, according to new guidelines from the US Preventive Services Task Force (USPSTF).
Many pediatricians perform autism screenings for toddlers and preschoolers, but it is not possible to determine whether this is a useful or harmful practice.
“Our recommendation is not a recommendation against screening, but a call for more research,” said Dr. David Grossman, vice chair of the USPSTF.
“So far, research has appropriately focused on treatments for children who have symptoms, especially those who are severely affected,” Grossman added.
Reuters reports that more research needs to be done. Roughly 2% of US youngsters may have autism spectrum disorders (ASD) that can influence behavior, social skills, and communication. There are a variety of early symptoms that include resistance to change, body rocking, repetitive behaviors, and at times aggression.
Again, evidence is not available that would suggest that treatment or screening could be harmful to young people, but interventions or investigative tests could put needless hardships on some families with regard to costs and time, reports the USPSTF. The recommendations were published in the Journal of the American Medical Association.
The American Academy of Pediatrics suggests that all children from 18 to 24 months be screened for autism.
Some health professionals are concerned that if screening children from 18-30 months is eliminated pediatricians will lose the opportunity for early intervention, which in turn could worsen inequalities in the treatment of autism, writes Shefali Luthra for Kaiser Health News.
Bernard Dreyer, president of the American Academy of Pediatrics and a practicing New York pediatrician, said a large amount of research has shown that the earlier doctors can interpose with a developmental issue the better it will be for the child.
Since the AAP has said since 2007 that testing every child for ASD should be routine, many pediatrics experts say this should carry enough weight to ensure that the screening is covered by most health insurance plans.
Samantha Costa writes for US News and World Report that the USPSTF suggests that doctors and parents use their best judgment as to whether or not to screen. But an editorial by Dr. Jeremy Veenstra-VanderWeele of New York Presbyterian Hospital in New York and Dr. Kelly McGuire of Maine Behavioral Healthcare in Portland, published in JAMA Psychiatry, disagrees with the USPSTF’s “gray zone.”
“This non-recommendation is most jarring when juxtaposed against the decision that the guideline should not apply to children when the health care professionals have concerns about ASD,” they wrote.
The USPSTF is made up of 16 physicians who are empowered by Congress and supervised by a division of the US Department od Health and Human Services, reports Disability Scoop’s Michelle Diament.
Autism Speaks called out the task force for risking that families and insurers might become confused concerning the value of autism screening. They quote Susan Levy of The Children’s Hospital of Philadelphia and the University of Pennsylvania who said that without the screenings, some youngsters, especially if they have subtle developmental issues, could be overlooked.
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