Screening advocates say better, more-widespread screening is needed to boost early intervention and treatment. “So if we can identify kids earlier, while their brains are growing and developing rapidly, we have a much better chance to really make a difference in their lives and future”, says Thomas Frazier, Ph.D., of Cleveland Clinic’s Autism Center.
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Dr. David Grossman, vice chair of the USPSTF, declared that the panel do not recommend against screening but rather asks for more research to be done on the matter.
Some studies show the rate of autism has risen significantly since 2000, when one in 150 children were diagnosed with the disorder which can involve difficulty in social settings, increased sensitivity to certain stimuli, and either learning disabilities or above-average intelligence.
A leading USA advisory panel concluded on Tuesday (Feb 16) there is no need to screen all children aged 18 to 30 months for autism, a disorder that has become more common in recent years.
USPSTF’s judgment that there is insufficient evidence to screen all young children for autism stands in contrast to the nation’s largest group of pediatricians as well as leading autism advocacy groups. Behavioral, educational, speech and language therapy may help reduce the severity of autism symptoms in some children. Treatment studies were generally very small, few were randomized trials, most included children who were older than would be identified through screening, and all were in clinically referred rather than screen-detected patients.
– There isn’t enough evidence yet to say for sure whether toddlers and preschoolers need screening for autism even when they don’t have symptoms of the developmental disorder, new US guidelines conclude. “It’s just that we don’t know”, Grossman says. Health insurance coverage of ASD screening should not be impacted by the USPSTF statement.
The authors note that the recommendation is applicable for children (aged 18 to 30 months) who have not been diagnosed with ASD or developmental delay, and for whom no concerns of ASD have been raised by parents, caregivers, or health care professionals.
One of the concerns issued by the task force was the possibility of over screening or ‘false-positives’. Dawson says that may be a high bar to cross. “But because the AAP recommends autism screening, it’s still covered under the Affordable Care Act”. But usually those children are flagged for screening because a parent or caregiver sees behavior they think is troubling. The task force’s recommendations can have significant impact within the medical community.
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In an editorial in JAMA Psychiatry, Jeremy Veenstra-VenderWeele, an associate professor of psychiatry at Columbia University, said families of means who suspect something is amiss will press hard for a referral for screening, “Whereas the family without those resources won’t necessarily push or be in a position to push in the same way”. He further said “what we do know is that screening works”.
