A closer look at early autism assessments

Today’s guest bloggers are Carol Anne McNellis, Psy.D., clinical director at Devereux PA Children’s IDD Services and a member of the Devereux PA Autism Resource Team and Todd Harris, Ph.D.,  the director of Autism Services for Devereux Pennsylvania and Devereux’s National Autism Consultant. This is the first of a two parts.

The U.S. Preventive Services Task Force recently reviewed evidence on the benefits of screening toddlers and preschool-age children who have not raised concerns with caregivers or health care professionals for Autism Spectrum Disorder. The USPSTF is a panel of experts that reviews scientific evidence and makes recommendations regarding health screening procedures.

In this case, the panel concluded that there is insufficient evidence to adequately assess the benefits and harms of routine screening for ASD in children and recommended more research to help it make a concrete determination. In its article, published in the Journal of the American Medical Association, the task force stressed that it is not advising for or against autism screening at this time, simply that more should be done to assess the efficacy of evaluation for toddlers and children that have not displayed symptoms.

Many organizations in the field of autism, including Devereux, the Autism Science Foundation and Autism Speaks, continue to support ongoing developmental surveillance and specific autism screening at 18 months and 24 months in all children, as well as whenever a parent has any sort of concern. Routine assessment ensures greater access to early interventions for all children. Treatment research clearly demonstrates the need for early diagnosis and prompt intervention as intensive and individualized behavioral interventions can mitigate the impact of the core symptoms. If not a routine part of a check-up, parents should ask their pediatrician for an autism screening when their child is 18 months old.

Understanding Autism and Its Early Symptoms

Autism is best understood as a “spectrum disorder,” reflected by its diagnostic term Autism Spectrum Disorder, because its symptoms fall on a continuum. Some individuals may demonstrate very mild symptoms, while others may present more severe symptoms.

The core difficulties of ASD include social interaction, communication and behavior. Individuals with ASD often have difficulty relating to others, engaging in eye contact and initiating conversations. Communication challenges, both verbally and nonverbally, are another hallmark of ASD. About 40 percent of individuals with ASD do not speak, but learn to communicate through other means. Individuals with autism may have restricted thinking and behavioral patterns. Many dislike change and insist on routine and sameness.

Children on the spectrum require immediate clinical, educational and social services and supports. Key behavioral signals of autism in infants and toddlers include:

  • Unusual visual fixations and hyper-focused interests
  • Abnormal repetitive behaviors, like rocking and head banging
  • Delayed development of age appropriate sound development, like the simple ‘ma ma’ or ‘da da’ sounds
  • Delayed intentional communication
  • Difficulty maintaining face to face interaction and a greater interest in objects

Parents should be aware that symptoms may begin in early infancy, and generally most children will exhibit some symptoms during their first year. Regardless of whether symptoms are mild or severe, children who exhibit these behaviors should see a pediatrician as soon as possible. Pediatricians can use a simple autism screening tool to advise families if their child requires further evaluation.

In our next post, we will discuss more about assessments and what happens after a child goes through an assessment.


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