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Thursday, November 30, 2017

A Case for Screening

Zoë Kirsch at Slate:
Recent research suggests that, by 2, toddlers can begin to reveal signs of autism: an absence of big smiles or, as in Jonathan’s case, an abrupt loss of speech and a lack of interactive gestures. But most children with autism aren’t identified until after they turn 3 (the median age of first diagnosis is 3 years and 10 months). By then, in most states, kids are no longer eligible for the array of services that Jonathan gets on a weekly basis—a delay that robs them of time that could have been used to catch up to peers.

Research shows that black and Hispanic kids are less likely than their non-Hispanic white counterparts to be evaluated before 3, and that, on average, black and Latino children are diagnosed later than their white peers — with a delay of 1.4 and 2.5 years, respectively. Kids who communicate in a language other than English at home are 48 percent less likely than English speakers to be referred to early intervention. It’s a stark example of how children who haven’t even learned to brush their own teeth may already suffer due to the color of their skin or the language that they speak.
In 2007, the American Academy of Pediatrics recommended that doctors screen all toddlers for autism at their 18- and 24-month visits, when indicators start to stabilize. Since then, the average age of diagnosis in some communities has dropped by roughly a year and a half, according to a 2016 study by researchers at Albert Einstein College of Medicine in the Bronx.
Studies show that kids who start treatment early demonstrate increased social and cognitive functioning which can, in turn, result in more independence. In a recent paper, researchers at the New England Center for Children analyzed gains among dozens of children who began the same early intensive behavioral intervention at ages 1, 2, and 3, and found that those who started therapy youngest saw the most improvement.

Early signs of autism can masquerade as the typical struggles that bilingual kids confront when learning a second tongue: The key to distinguishing one from the other is knowing that a bilingual child with a learning impairment will struggle in both languages, not just one.
There is no guarantee of dramatic progress.
A study out of the Bronx found that just 1 in 14 toddlers who received early intervention services improved to the point that they no longer needed services in first grade