Is Autism Screening Necessary For Toddlers?

The US Preventive Services Task Force (USPSTF) presents its findings in the current issue of JAMA.

Autism Spectrum Disorder (ASD) affects approximately one in 68 children in the United States, affecting social, communication, and behavioral skills. Often, symptoms begin in early childhood. So, when JAMA  (The Journal of the American Medical Association) published the findings of the USPSTF (US Preventive Services Task Force), a government-backed panel of independent doctors, regarding the importance and efficacy—or lack thereof—of early-childhood screening, reactions from the public and the medical community were mixed.

According to Reuters Health, Dr. David Grossman, vice chair of the USPSTF, explained, “Our recommendation is not a recommendation against screening, but a call for more research.” At this point, he said, “research has appropriately focused on treatments for children who have symptoms, especially those who are severely affected” by ASD.

However, since the USPSTF’s recommendations are often used by insurance companies to make coverage decisions, the fact that USPSTF concluded that “the current evidence is insufficient to assess the balance of benefits and harms of screening for ASD in young children for whom no concerns of ASD have been raised by their parents or a clinician” has caused parents, as well as many in the medical community, to be concerned. In an editorial in JAMA Psychiatry, Dr. Jeremy Veenstra-VanderWeele of Columbia University wrote that the American Academy of Pediatrics recommends screening all children for autism at 18 and 24 months, and he told Reuters Health that  “this is what pediatricians are supposed to be doing, and should continue to do.”

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Melissa Bianchini, LCSW, executive director of Sensory Stepping Stones in Mount Kisco, said, “I agree that it is what pediatricians are supposed to be doing and should continue to do, as it helps those children who are truly suffering from this diagnosis. Unfortunately, because the USPSTF recommendations are the ones that our insurance companies use to make coverage decisions, there may be a conflict with pediatricians conducting the screenings or the therapies that they can obtain if there is no reimbursement.”

Symptoms of ASD in young children can vary, but often telltale symptoms, or “red flags,” according to Autism Speaks, include “no big smiles or other warm, joyful expressions by six months or thereafter; no babbling by 12 months; no back-and-forth gestures such as pointing, showing, reaching, or waving by 12 months; no words by 16 months; no meaningful, two-word phrases by 24 months.” Other signs of ASD include body rocking, hand-flapping, repetitive behaviors, and resistance to changes in routine.”

What do you think? Do you agree with the USPSTF or the American Academy of Pediatrics? Let us know in the comments.

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