The Need For Autism Screening
It is reasonable to question the value of incorporating a new screening procedure when we are pressed on time and resources. And since most of us already use milestone checklists and our clinical judgment, you may wonder why autism screening is necessary.
If we are able to detect autism spectrum disorders earlier and these children receive early intervention, this can potentially lead to a better prognosis. Early intervention has been shown to limit long term morbidity. Participants have higher graduation rates, higher employment rates, and less criminality than those who did not receive EI. (Kleinman, et al: The Modified Checklist for Autism in Toddlers: A Follow-up Study Investigating the Early Detection of Autism Spectrum Disorders, 2008).
We have frequent contact with children under three and therefore play a crucial role in identifying children at risk for autism spectrum disorders (Pinto-Martin, et al: Screening Strategies for Autism Spectrum Disorders in Pediatric Primary Care, 2008).
While we carefully monitor our patient's developmental progress, research has shown that physician estimates of the developmental status of children are much less accurate when only judged with clinical impressions, rather than when formal screening tools are used. Yet, only a minority of us uses formal developmental screening tools, and even fewer of us screen for autism spectrum disorders (Johnson, et al: Identification and Evaluation of Children with Autism Spectrum Disorders, 2007).
Though most of us use checklists of developmental skills, these do not provide standardized cut-offs for the number of missed milestones that indicate a need for referral. Validated tools, by contrast, provide standardized data to guide practice and assure uniform care for all patients.
Fortunately, the tools that help us identify children at risk for autism spectrum disorders finally exist. These tools enable early intervention, which in turn increases the quality of care by your practice. It is also important to note that autism screening boosts the identification rate at low cost to time and budget.
- Current prevalence of ASDs is approximately 1 per 110 (CDV.gov, accessed 3/2010)
- Many parents report being concerned about their child between 15-18 months, but delay discussing these concerns with their providers for several months
- Intensive early intervention, including by trained practitioners and parents, can improve IQ, language ability, and social interaction (Dawson, et al. 2010, Randomized, Controlled Trial of an Intervention for Toddlers With Autism The Early Start Denver Model, Pediatrics, 125, pp. e17-e23)