Every parent wants their children to grow up to lead happy, healthy lives. A child’s early months and years are critical developmental years and, as a pediatrician, I encourage parents and caregivers to talk with their child’s doctor about any concerns they might have, no matter how small.
During routine check-ups, I talk with parents about how their child is developing and ask about any concerns they may have. Over the past few years, more parents and caregivers have approached me with concerns about autism. Autism is a developmental disorder that affects a child’s ability to communicate and interact. Because the signs and symptoms of autism vary from child to child, and are mild in some children and more severe in others, it is now called ” autism spectrum disorder.” Identifying autism and other developmental disorders is the first step toward helping children and families get the support they need.
For this reason, my colleagues and I, as part of the U.S. Preventive Services Task Force, looked at the best available research on the benefits and harms of screening for autism in young children. A screening test is used by pediatricians and other primary care clinicians to check for conditions in children who do not have recognized symptoms of an underlying disorder. In our review, we focused specifically on studies of children who didn’t exhibit any apparent symptoms of autism or delay in development. The question is this: Should we attempt to screen all children for subtle indicators of autism or wait until these symptoms become apparent to parents and clinicians? Does earlier intervention make a difference for these children at this stage? And what are the harms, such as worry and labeling, for children who screen positive but are ultimately not diagnosed with autism?
What we found is this: We need more research to help us better understand the role of screening young children under three years for autism. For example, we need more research to determine the best ages to screen, the best screening tools to use, and whether screening all children ultimately helps their development and improves their quality of life. Our review found no studies that could tell us whether screening for autism in kids under three years of age without apparent symptoms leads to important benefits such as improvements in school achievement, cognitive and intellectual functioning, or the development of language and communication skills.
Our recommendation does not apply to kids who have already been diagnosed with autism or a developmental delay, or who are being evaluated or referred for developmental concerns by doctors or parents. Parents who do have concerns about their child’s development should talk to their pediatrician or other health care provider. And in the face of unclear evidence, we encourage doctors to use their clinical judgment when deciding whom to screen and when to test young children without apparent symptoms for autism.
We also want families to understand that our findings are still at the draft stage. It’s also important to note that this is not a recommendation against screening. Rather, it’s a recognition that the evidence is insufficient, and more research is needed.
Our goal is to help young children with autism get the care and support they need, and to provide parents and doctors with the best evidence about the effectiveness of screening. Please add your voice to this important dialogue and our call for more research into this critical issue for children and families.
Dr. David Grossman is the vice chair of the U.S. Preventive Services Task Force.
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What Every Parent Should Know About Autism Screening originally appeared on usnews.com
