From Our 2012 Archives
Most Children With Autism Diagnosed at 5 or Older
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Data Provide Snapshot of Autism Spectrum Disorder and Special Health Care Needs
By Denise Mann
Reviewed by Louise Chang, MD
May 24, 2012 -- New research provides a snapshot of what life is like for school-aged children with autism spectrum disorder in the U.S.
The findings, which appear in the NCHS Data Brief, highlight areas where there is room for improvement, including earlier diagnosis of autism spectrum disorder and access to behavioral therapies and other services. The new study looked at children aged 6 to 17 with special health care needs and autism spectrum disorder in 2011.
More than half of school-aged kids were age 5 or older when they were first diagnosed with autism spectrum disorder, the study showed. Less than 20% were diagnosed by age 2. The American Academy of Pediatrics recommends that pediatricians screen children for autism at 18 months of age.
The CDC estimates that 1 in 88 children in the U.S. has an autism spectrum disorder. This is the umbrella term for a group of developmental disorders that can range from mild to severe and that often affect social and communication skills. Treatment is individualized, and often involves behavioral therapies to address developmental delays along with medication.
Earlier Diagnosis of Autism Is Possible
Of the children in the study, about 9 of 10 received one or more therapies. Most commonly these included speech or language therapy and/or social skills training. More than half of these kids took at least one psychiatric medication, including stimulants, anti-anxiety drugs, or antidepressants.
"Our data indicate that many children with autism -- the majority -- are getting some sort of services such as speech or other individual-based interventions," says researcher Lisa J. Colpe, PhD, MPH, of the National Institute of Mental Health in Bethesda, Md. "That is great news."
Outside experts say there are still many gaps in the diagnosis and treatment of autism spectrum disorder among school-aged kids in the U.S.
"Research tells us that children who start intervention earlier do better in the long run," says Geraldine Dawson, PhD, in an email. She is the chief science officer at Autism Speaks. "We can reliably diagnosis autism by 24 months, so professionals need to do a better job, including screening all children at 18 and 24 months."
Data Highlight Gaps in Autism Treatment
In the study, 12% of kids with autism spectrum disorder didn't receive any of the suggested services. Less than half received the kind of behavioral therapies that are believed to be most helpful.
"There are many reasons children with autism are not receiving the interventions they need, including lack of insurance coverage and inadequate numbers of trained professionals," Dawson says. "It is critical that we address the barriers that are preventing children from receiving early intervention. "
Daniel L. Coury, MD, agrees. He is a professor of clinical pediatrics and psychiatry at Ohio State University and Nationwide Children's Hospital in Columbus, Ohio. He says that doctors need to do a better job of identifying autism earlier and getting these children into services at younger ages.
"If we can get more physicians to do that, it would be a start," he says. This is not going to pick up every child, as those more mildly affected may not be identified until their school years.
Amy Keefer, PhD, is a clinical psychologist in the Kennedy Krieger Institute's Center for Autism and Related Disorders in Baltimore, Md. She says that parents need to advocate for their children.
"Be involved with practitioners who are experts in autism at the first concern, and if a diagnosis isn't given, ongoing monitoring, assessment, and checking in can help guide parents through the developmental stages," she says.
SOURCES: National Center for Health Statistics: "Data Brief No. 97." Geraldine Dawson, PhD, chief science officer, Autism Speaks. Daniel L. Coury, MD, professor, clinical pediatrics and psychiatry, Ohio State University and Nationwide Children's Hospital, Columbus, Ohio. Amy Keefer, PhD, clinical psychologist, Kennedy Krieger Institute's Center for Autism & Related Disorders, Baltimore, Md. Lisa J. Colpe, PhD, MPH, National Institute of Mental Health, Bethesda, Md. CDC: "Autism Spectrum Disorders: What Should You Know?" American Academy of Pediatrics: "Is It Autism?"