Physicians Group Urges Early Autism Screening
The American Academy of Pediatrics, or AAP, is urging early screening for autism spectrum disorders, or ASDs, for all children.
The group, currently holding its annual meeting in San Francisco, released two new clinical reports on Monday, Oct. 29.
The co-authors of the reports, Dr. Chris Johnson, Clinical Professor of Pediatrics at University of Texas Health Science Center at San Antonio and Dr. Scott Myers, neurodevelopmental pediatrician at the Janet Weis Children’s Hospital/Geisinger Medical Center, discussed the reports in a press briefing.
At the briefing, they were joined by Andy Shih, vice president of scientific affairs for Autism Speaks. The first .report, “Identification and Evaluation of Children With Autism Spectrum Disorders,” calls for early screening and provides information on signs and symptoms to help pediatricians recognize ASDs in patients.
The second, “Management of Children With Autism Spectrum Disorders,” emphasizes early intervention and reviews treatments and educational strategies for children with ASDs. The reports are available on the AAP’s web site, www.aap.org:
Original Release Date: Monday, October 29, 2007 12:01 am ET
NEW AAP REPORTS HELP PEDIATRICIANS IDENTIFY AND MANAGE AUTISM EARLIER
SAN FRANCISCO – Two new clinical reports from the American Academy of Pediatrics (AAP) will help pediatricians recognize autism spectrum disorders (ASDs) earlier and guide families to effective interventions, which will ultimately improve the lives of children with ASDs and their families.
The first clinical report, “Identification and Evaluation of Children With Autism Spectrum Disorders,” provides detailed information on signs and symptoms so pediatricians can recognize and assess ASDs in their patients. Language delays usually prompt parents to raise concerns to their child’s pediatrician – usually around 18 months of age. However, there are earlier subtle signs that if detected could lead to earlier diagnosis.
- not turning when the parent says the baby’s name;
- not turning to look when the parent points says, “Look at…” and not pointing themselves to show parents an interesting object or event;
- lack of back and forth babbling;
- smiling late; and
- failure to make eye contact with people.
Most children, at some time during early development, form attachments with a stuffed animal, special pillow or blanket. Children with ASDs may prefer hard items (ballpoint pens, flashlight, keys, action figures, etc.). They may insist on holding the object at all times.
The report advises pediatricians to be cognizant of signs of ASD, as well as other developmental concerns, at every well-child visit by simply asking the parents if they or their child’s other caregivers have any concerns about their child’s development or behavior. If concerns are present that may relate to ASD, the clinician is advised to use a standardized screening tool. The report also introduces universal screening, which means pediatricians conduct formal ASD screening on all children at 18 and 24 months regardless of whether there are any concerns.
“Red Flags” that are absolute indications for immediate evaluation include: no babbling or pointing or other gesture by 12 months; no single words by 16 months; no two-word spontaneous phrases by 24 months; and loss of language or social skills at any age. Early intervention can make a huge difference in the child’s prognosis. “Autism doesn’t go away, but therapy can help the child cope in regular environments,” said Chris Plauche Johnson, MD, MEd, FAAP, and co-author of the reports. “It helps children want to learn and communicate.”
Educational strategies and associated therapies, which are the cornerstones of treatment for ASDs, are reviewed in the second AAP clinical report, “Management of Children With Autism Spectrum Disorders.”
Early intervention is crucial for effective treatment. The report strongly advises intervention as soon as an ASD diagnosis is seriously considered rather than deferring until a definitive diagnosis is made. The child should be actively engaged in intensive intervention at least 25 hours per week, 12 months per year with a low student-to-teacher ratio allowing for sufficient one-on-one time. Parents should also be included.
Pediatricians who treat children with ASDs should recognize that many of their patients will use nonstandard therapies.
The report says it’s important for pediatricians to become knowledgeable about complementary and alternative medicine (CAM) therapies, ask families about current and past CAM use, and provide balanced information and advice about treatment options, including identifying risks or potential harmful effects. They should avoid becoming defensive or dismissing CAM in ways that convey a lack of sensitivity or concern, but they should also help families to understand how to evaluate scientific evidence and recognize unsubstantiated treatments.
“Many parents are interested in CAM treatments such as various vitamin and mineral supplements, chelation therapy, and diet restrictions. It’s important for pediatricians to maintain open communication and continue to work with these families even if there is disagreement about treatment choices, ” said co-author of the reports Scott M. Myers, MD, FAAP.
“At the same time, it’s also important to critically evaluate the scientific evidence of effectiveness and risk of harm and convey this information to the families, just as one should for treatment with medication and for non-medical interventions.”
Although use of the gluten-free/casein-free diet for children with ASDs is popular, there is little evidence to support or refute this intervention. More studies are in progress, and it is anticipated that these studies will provide substantially more useful information regarding the efficacy of the gluten-free/casein-free diet.
Tantrums, aggressive behaviors, and self-injury are common among children with ASDs, and medical factors may cause or exacerbate these behaviors. Behavior management strategies are often the most effective treatment for challenging behaviors. In some children, medications are effective in addition to the behavioral strategies. The report addresses the medical issues that some children with ASDs encounter such as seizures, gastrointestinal problems, and sleep disturbance, and provides guidance for medication management.
Both reports will also be part of the new AAP practical resource for pediatricians “AUTISM: Caring for Children with Autism Spectrum Disorders: A Resource Toolkit for Clinicians,” which includes screening and surveillance tools, guideline summary charts, management checklists, developmental checklists, developmental growth charts, early intervention referral forms and tools, sample letters to insurance companies and family handouts.
For more information and resources, please see the Autism Health Topic page.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.