New autism guidelines target early detection

Children's Health

Pediatricians should initiate treatment of children showing signs of autism spectrum disorder (ASD) even before tests confirm a diagnosis, the newest recommendations from the American Academy of Pediatrics reports.

The first update in 12 years, the new guidelines came from a scientific working group that conducts consultations with doctors and family groups. The update can help doctors identify at-risk children and get them the needed care and medical attention as early as possible.

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Recent research authored by the AAP Council on Children with Disabilities and the AAP Section on Developmental and Behavioral Pediatrics had driven the changes made as it studied on the neurodevelopmental disorder that affects an estimated 1 in every 59 children.

The clinical report, which was published in the journal Pediatrics, highlights the importance of identifying and detecting autism early, which can be diagnosed as a year as 18 months old. The study has contributed to the new recommendations which were not updated since 2007.

Way back when the guidelines were updated more than a decade ago, the research that examined the possible causes of autism spectrum disorder had been limited, but in time, the understanding has progressed rapidly, increasing the body of knowledge about the factors that interplay in the development of the condition.

Today, doctors and health experts have better knowledge and understanding of the condition, and how environmental and genetic factors drive the development of ASD. Further, supporting evidence-based interventions have been developed substantially, providing better treatment options for children with ASD.

Early detection is crucial

Since developmental delays are present in very young children with autism, the report urges doctors to detect issues even during healthy baby visits and refer children with signs of autism accordingly.

“We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes,” Dr. Susan L. Hyman, lead author of the report, said.

“There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies. Interventions work best when they are early when they are intense, and when they involve the family,” she added.

The report also focused on educating pediatricians and the other members of the healthcare team about how they can detect children with autism early and how they can make early referrals. Also, the researchers encourage doctors to provide families with treatment options founded by evidence-based research and steer away from those which have not been scientifically proven.

New AAP recommendations

The AAP recommends that pediatricians perform both behavioral and developmental surveillance during healthy baby visits and developmental screening consultations at 9 months, 18 months, and 30 months of the baby. It also encourages that doctors conduct a standardized patient screening for ASD at 18 months and 24 months of age of the child.

Doctors should also provide children with evidence-based services for their varied needs at home and in school. They should be given proper pediatric and mental health care, along with addressing their academic, behavioral, and social needs.

The families should also be included in the treatment plan of the patient. The families should engage to plan a transition to the medical and behavioral care in adulthood. Lastly, the AAP recommends that patients and their families should be informed about new interventions backed by research and refer them to participate in support organizations and new clinical research.

ASD by the numbers

There are an estimated 5 million people in the United States who are living with autism spectrum disorder. Based on the latest data, there is now 1 in 59 children who has ASD, which increased from 1 in 155 in 2007.

Autism spectrum disorder (ASD) is a developmental and neurological disorder that starts early in childhood. It’s a condition that goes in throughout a person’s life and it affects how a person interacts with others, learns, and communicates.

Many people with ASD have co-occurring conditions that should also be treated, including attention-deficit/hyperactivity disorder, anxiety, intellectual disability, sleep disorders, language disorders, seizures, and gastrointestinal problems.

Journal reference:

Hyman, S., Levy, S., Myers, S., and the Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. (2019). Identification, Evaluation, and Management of Children with Autism Spectrum Disorder. Pediatrics.

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