Autism: Early Screening by Pediatricians

Medical Author: David Perlstein, MD, MBA, FAAP
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

It is commonplace to have a family member or close friend with a child diagnosed with one of the autism spectrum disorders (ASDs, including autistic disorder, Asperger disorder, pervasive developmental disorder). These are a set of neurodevelopmental disabilities affecting young children and adults, which are currently not considered "curable." The goals of management include minimizing the symptoms and maximizing both independent function and quality of life. These are not uncommon disorders. A recent report from the CDC funded Autism and Developmental Disabilities Monitoring (ADDM) Network 2012 report published that the prevalence of 8 year old children diagnosed with ASDs had increased from 6.5 per 1,000 children (1 in every 150 children) in 2002 to 11.3 per 1,000 children (1 in every 88 children) in 2008. Many believe that there is an "autism epidemic." However, as with many diseases and disorders, there are many reasons for this high prevalence. Moreover, researchers continue to explore the many factors that cause autism.

Fortunately, significant media coverage and increased research have resulted in a better-educated public and more vigilant health care professionals. We are much better at screening and identifying children and infants at risk, better at documenting the diagnoses, and better at intervening earlier. It has been clearly shown that early diagnosis and intervention are usually associated with better outcomes. A recent study from Columbia University and published in the medical journal Pediatrics noted that there was even a subgroup of severely affected infants with ASD who, with an appropriate intervention, “experience rapid gains, moving from the severely affected to high functioning.” They named this group “bloomers.” This alone justifies universal screening, early identification, and intervention.