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Saturday, January 16, 2016

The Screening Controversy

In The Politics of AutismI discuss screening and diagnosis.

Kamala Kelkar reports at The Guardian:
The US Preventive Services Task Force is evaluating a final recommendation to clinicians that there is not enough science to promote universal screening for children under three, prompting alarm from many researchers and clinicians in the field.
Backers of universal screening say doctors have been encouraged to conduct more autism screenings, which are crucial to early intervention, by the AAP’s recommendation that all children get screened. They say this new recommendation could take them a dangerous leap backwards.
“I fear that people will stop screening,” said Dr Susan Levy, who chairs the AAP’s subcommittee on autism. “The earlier you identify the child and refer them for treatment the better the outcome is.”
Dr Daniel Coury said during a review of the universal screening recommendation Tuesday that some autistic children only show symptoms 10% of the time, which could be too subtle for untrained eyes.
“There seems to be adequate evidence there to continue to screen … Anything that might take a step backward certainly concerns me and most pediatricians in this country,” said Coury, chief of the Section of Developmental and Behavioral Pediatrics for Nationwide Children’s Hospital in Columbus, Ohio.
Dr Amy Wetherby, the director of the Autism Institute at Florida State University, cited a statistic that only 2.5% of toddlers who need it are receiving special education, citing the need for more reliable screening tools.

Dr Karen Pierce, co-director of the Autism Center at the University of California, San Diego, pointed to the plasticity of a toddler’s brain between birth and the age of two as a reason why early treatment is crucial. The current average age for diagnosis is around 4, but she argues that it could be as young as two.