Search This Blog

Tuesday, August 25, 2015

Explaining the Recommendation on Screening

 In The Politics of AutismI discuss screening and diagnosis.  At US News, Dr. David Grossman, vice chair of the U.S. Preventive Services Task Force, explains its recommendations about screening:
[M]y colleagues and I, as part of the U.S. Preventive Services Task Force, looked at the best available research on the benefits and harms of screening for autism in young children. A screening test is used by pediatricians and other primary care clinicians to check for conditions in children who do not have recognized symptoms of an underlying disorder. In our review, we focused specifically on studies of children who didn't exhibit any apparent symptoms of autism or delay in development. The question is this: Should we attempt to screen all children for subtle indicators of autism or wait until these symptoms become apparent to parents and clinicians? Does earlier intervention make a difference for these children at this stage? And what are the harms, such as worry and labeling, for children who screen positive but are ultimately not diagnosed with autism?
What we found is this: We need more research to help us better understand the role of screening young children under three years for autism. For example, we need more research to determine the best ages to screen, the best screening tools to use, and whether screening all children ultimately helps their development and improves their quality of life. Our review found no studies that could tell us whether screening for autism in kids under three years of age without apparent symptoms leads to important benefits such as improvements in school achievement, cognitive and intellectual functioning, or the development of language and communication skills.

Our recommendation does not apply to kids who have already been diagnosed with autism or a developmental delay, or who are being evaluated or referred for developmental concerns by doctors or parents. Parents who do have concerns about their child's development should talk to their pediatrician or other health care provider. And in the face of unclear evidence, we encourage doctors to use their clinical judgment when deciding whom to screen and when to test young children without apparent symptoms for autism.