Sunday, September 13, 2015

Should autism screening take place during pediatric check-ups?

In August, the U.S. Protective Services Task Force (USPSTF) - a federally-funded panel of experts in primary care and prevention- released a statement that concerned many in the autism community. The panel concluded that current evidence is not sufficient to prove that screening children under three years old  for autism spectrum disorder (ASD) during primary care visits results in better outcomes for those children who do go on to be diagnosed with ASD. The panel recommended extensive further research to determine whether there is a direct link between universal screening for ASD and better treatment outcomes. The panel's conclusions run counter to those of the American Academy of Pediatrics, which are considered best practice by most autism research and advocacy organizations. So, we asked 3 CAR scientists to help cut through the confusion. 


Susan E. Levy, MD, is a developmental pediatrician at CHOP and chairs the AAP's Subcommittee on Autism.
"My immediate concern is that parents and general pediatricians will misinterpret the recommendations to mean that universal screening isn’t worth it. And that is far from the truth.“If we wait for the perfect screening tool, we’re going to miss the opportunity for early identification - and therefore early intervention, which we know is the most important factor in improving ASD symptoms.”



David S. Mandell, ScD
, is Associate Director of CAR and  of the Center for Mental Health Policy and Services Research at the University of Pennsylvania's Perelman School of Medicine. 


"If you’re a physician who has 10-15 minutes with a patient, the screening is critical because it gives physicians information they just wouldn’t otherwise have a way to collect during that very brief interaction with the child.... I think the evidence we have available now is strong enough to suggest that screening identifies children with ASD and that high quality treatment is effective. I really think that should be enough to uphold the value of universal screening.”

 
 

Juhi Pandey, PhD, is a pediatric neuropsychologist at CAR and Clinical Assistant Professor of Psychology at the University of Pennsylvania's Perelman School of Medicine. 
"Targeted screening at specific ages- rather than screening only when the clinician or parent raises a concern- takes away any inherent bias. No matter how strong a practitioner's clinical judgment is, or no matter how well a parent knows their child, we are human. We need standardized testing at regular intervals to make sure our biases aren't causing us to over-or under-estimate a child’s developmental functioning."

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