The American Academy of Pediatrics has issued new guidance on autism for the first time since 2007. The biggest changes are a call for early treatment and recommendations that doctors include check ups for developmental delays at every well-child visit for all children.
What is autism?
Autism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by difficulties with communication and social interaction, as well as repetitive or restricted movements. Parents might notice these issues in their child’s first three years of life, and pediatricians hope to provide an early diagnosis.
The Centers for Disease Control estimate that 1 of 59 American children has some form of ASD. This is a larger percentage of children than were diagnosed the last time the AAP issued a report on the subject. Early intervention has been shown to have more positive outcomes later in life, and the evidence for the value of interventions has increased since that time.
This is why early, frequent screenings are recommended for all children.
The new guidelines from the AAP recommends developmental screening at 9, 18 and 30 months, plus autism-specific screening at 18 and 24 months. These screenings are suggested for all children. One current type of screening is the M-CHAT-R. This could give you an idea of the kinds of questions that might be asked to screen for autism at an early age.
The Academy says that it is possible to diagnose autism as early as 18 months. However, some therapies can begin before an official diagnosis. For example, language delays can be treated without a diagnosis of autism.
Autism Navigator provides resources for families, including video showing typical toddlers and toddlers with signs of ASD.
Screening is not diagnosis
Screening is now recommended for all children. If routine screenings suggest that children might be at risk of a diagnosis of ASD, further diagnostic testing should take place. Tests might include specialized assessment of language ability, tests of vision and motor skills, and clinical observation.
There are no lab tests that can diagnose ASD at this point. Diagnosis is based on observable behaviors. Autism is diagnosed only when differences interfere with function. This may mean that diagnosis takes place after a child begins school.
Parents can discuss any concerns about autism with their pediatrician.