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Thursday, March 10, 2016

A Case for Screening

In The Politics of AutismI discuss screening and diagnosis.

At The San Diego Union-Tribune, Eric Courchesne and Karen Pierce argue against the recent declaration of the U.S. Preventive Services Task Force (USPSTF), that there was insufficient evidence to support routine primary care screening of very young children for ASD
In recent years, scientists have developed several simple checklists to detect ASD in toddlers at their well-baby exams. Autism spectrum disorder’s warning signs are subtle at that age, but they exist. In fact, the task force recommendation notes that such checklists are indeed effective at detecting ASD.
That’s why the USPSTF’s suggestion that there isn’t enough scientific evidence to support routine early screening for autism spectrum disorder in all toddlers isn’t just perplexing, it’s irresponsible. It threatens to delay care and services to young children with undetected autism who could truly benefit.
The USPSTF presents a skewed picture of the state of clinical screening and its value. The task force suggests early routine screening might be unwise because perceived benefits do not outweigh unspecified “harms,” particularly to “children for whom no concerns (of ASD) have been raised by their parents or clinical provider.”

But that is exactly the point of routine early screening: To identify toddlers who may have ASD but do not yet display obvious symptoms or behaviors. The efficacy of early screening has been proven time and again. Indeed, our own screening research has shown that ASD can be detected and treatment started by 17 months — several years earlier than the national average of 4 years. Screening for ASD during routine checkups, as recommended by the American Academy of Pediatrics is the single most positive and successful public health policy ever created for children affected by autism.