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Study: Autism Can Be Diagnosed In Minutes


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It often takes hours for a clinician to diagnose a child with autism, but a Harvard researcher now says it may be possible to complete an assessment that’s just as accurate within minutes.

Using a Web-based tool that relies on just seven questions and a short home video, Dennis Wall, a researcher at Harvard Medical School, says he can provide a near perfect assessment of whether or not a child has autism.

“We believe this approach will make it possible for more children to be accurately diagnosed during the early critical period when behavioral therapies are most effective,” Wall said.

In contrast, children are typically diagnosed through lengthy, clinical evaluations. One popular method known as the Autism Diagnostic Interview, Revised, relies on 93 questions.

The new method developed by Wall can cut diagnosis time by almost 95 percent, researchers said in a paper about the approach that was published Tuesday in the journal Nature Translational Psychiatry.

When tested against traditional methods in more than 1,000 cases, Wall says that his shortened diagnosis procedure achieved near perfect accuracy.

The development could be significant, given the rising number of children with autism. Just last month the U.S. Centers for Disease Control and Prevention reported that autism prevalence increased to 1 in 88 children, up from 1 in 110. At the same time, the government agency said most children still aren’t diagnosed by age 3, meaning that they are missing out on several critical years of early intervention.

Wall says his method could be pivotal in allowing for more kids to be diagnosed at younger ages since families can take initial steps toward getting a diagnosis without leaving home.

However, many others within the autism community are skeptical that an accurate diagnosis could be achieved without any face-to-face interaction with an expert.

“Arguing you should do this via a five-minute video and a seven-minute questionnaire is ridiculous,” Catherine Lord, the director of the Center for Autism and the Developing Brain at New York Presbyterian Hospital, told TIME. “Even if you do identify a child with autism, it’s not an adequate diagnosis. You still are going to have to talk to parents and interact with the child.”

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Comments (10 Responses)

  1. Michael Cocchiola says:

    I suggest that any clinician step with great caution towards a nearly ‘spontaneous’ diagnosis of Autism. First, there are other underlying and potentially important diagnoses dovetail with the symptoms of autism and need to be ruled out first (Dravet’s Syndrome, Landeu Kleffner Syndrome, Communication Disorder-NOS, Stereotyped Movement Disorder, Intellectual Impairment, Deafness, to name a few). Although educational and behavioral treatments of these disorders may closely resemble those for children with autism, they simply are not autistic and should not be labeled as such.

    Secondly, autism is considered a life-long disability with impairments in the 3 sub-domains of communication, socialization and perseveration/ ritualistic behaviors. These deficits should be carefully scrutinized to ensure that they are indeed permanent deficits in a persons repertoire—a short questionaire does this no justice.

    Finally, autism comes in varying degrees of severity. A child with classic autism is often readily identified, though children with lesser degrees of autism may indeed require treatment based on careful evaluation and prescribed interventions that meet their needs. A brief questionnaire may over-diagnose or under-diagnose the presence of autism spectrum disorders.

    Think about it this way—-if I think I broke my arm skiing, I would go to my doctor to have it examined and treated. If my doctor looked at it visually and put a cast on it, I would step out of the office and get a second opinion. Any physician in his right mind would prescribe an X-Ray first to confirm that the arm is indeed broken and decide on best practice for taking care of the issue. A short questionnaire to declare a life-long diagnosis is like the physician who does not bother with the basic tools of science to confirm that my arm is broken, where it is broken and best treatment to correct the issue. In a nutshell, bad professional practice.

  2. Steve says:

    This will at least put a stop to the many charlatan’s who assess a child, give the PDD NOS diagnosis and then say at the end of the report, “please return in 1 year for a complete evaluation….”

  3. Rachal Bales says:

    For those who are experienced autism does not have to be dxd through lengthy clinical assessments. I believe part of the problem stems from the myth that autism is “rare” and clinicians are trying to find any reason why “this can’t be autism” especially in higher functioning ppl. Clients then end up with 4 or 5 other dxs that reflect sxs secondary to autism/aspergers like anxiety, depression, ocd, social anxiety, etc.

  4. Ann Murray says:

    I am at the end of my rope with the increasing rise in rates of Autism being diagnosed and HAVE to question those “professionals” who are contributing to the statistics. First of all, I keep hearing about The American Academy of Pediatrics. Autism is considered a neurodevelopmental disorder yet . . . I have yet to see ONE neurologist interviewed and a GROUP of neurologists giving their opinion on the rate of increase in this diagnosis.
    Secondly, I personally know of two children who have been diagnosed with Autism who have NONE of the characterics of the disorder, make eye contact, have speech (some garbled, but speech nonetheless; and pointing and taking the hands of their family and leading them to items (they are both boys and 2 1/2 and 3 1/2 respectively) they want and shake their heads “yes” when they’re understood). They will actively engage you in play, smile but are very violent towards people, i.e., biting others, pulling glasses from faces, punching, biting, hair pulling, etc. . .
    Neither of them have been referred to neurologists and are continuing to be treated by. . .you guessed it, their pediatricians and medicated with Clonidine 2-3 times a day to “help settle them down so I can control them” is how the mothers/grandmothers put it. No other testing was done: no blood work, no MRI, no vision or hearing, nothing. Yet, because of the diagnosis of Autism, both children are receiving PT, OT, speech, cognitive behavorial therapy and Applied Behavorial Analayis (even doing fundraisers so the money doesn’t come out of their own pockets!) One of the parents even went to signed up their son for Early Childhood but was told by one of the therapists to NOT take the child because if the school “saw him and how he is”, they would KNOW and would refuse him entry but “once he’s enrolled, they can’t kick him out”.
    I have a son with Autism who is almost 25 years old and when I first took my concerns to him about my son, he immediately referred me to a speech and hearing center and then a neurologist. Twenty-two years later, I’m proud to say, I still have the same neurologist. Even changing pediatricians, the new one told me that he would not “treat the Autism” but would be happy to treat “pedi-problems” such as ear infections, colds, immunizations and such but didn’t feel qualified to deal with the intricacies of Autism.
    So, again, every single time the statistics change, I again ask myself, “what group of doctors are turning in the statistics and who is doing the diagnosis??” How QUALIFIED are these doctors to make this diagnosis?? Sure, my internist CAN can diagnose my broken arm but why would I NOT want to go to an ortho doctor who specializes in broken bones? I’m not slighting my own doctor, I just want to make sure I get the best care possible.
    How overwhelmed could our systems be with misdiagnosed children receiving services they don’t need and children who really need them being placed on waiting lists?? If the “1 in 88” statistic isn’t a wake-u[ call, I don’t know what is.

  5. Mike the Psych says:

    It is a pretty interesting study to attempt to create a screener version of the ADOS, I would be skeptical of its diagnostic utility though. The research itself is intriguing though and does reflect how it may be possible to further streamline the Autism Diagnostic Observation Schedule (ADOS) which is the gold standard in Autism identification.

    It would be very interesting to see the study replicated with an actual control group, which the researchers also pointed out. For those of you who have not yet read the full-text, the study made use of an artificial control group created from only 15 individuals assessed with the ADOS module 1 who were not classified. Although their method for creating this group appeared statistically adequate it is still tough to swallow that those 15 individuals were representative of the population at large without Autism. Additionally the abbreviated assessment is relatively strong in its accuracy to identify Autism only, not various degrees of the “spectrum” which will be a problem in the identification of higher functioning individuals. I would much rather see a study comparing it to other accepted brief screeners such as the M-CHAT instead of a diagnostic instrument like the ADOS.

  6. Rylin Hansen says:

    I think that Ms Lord misses the point: having this tool is a way that parents can find out whether they need to pursue further testing and treatment starting from an earlier age. This is a good thing!

  7. Annee says:

    …At the same time, the government agency said most children still aren’t diagnosed by age 3, meaning that they are missing out on several critical years of early intervention.

    Wall says his method could be pivotal in allowing for more kids to be diagnosed at younger ages since families can take initial steps toward getting a diagnosis without leaving home…

    I believe these are the key statements in this article. A quick review test given at home, might just move parents (who may know in their hearts that something is wrong, but are afraid to find out) to get further testing. It seems like a similar idea to the questions used to help people who think a loved one has alzheimer’s disease. A beginning.

  8. Gerard Costa, Ph.D. says:

    While such research may appear to offer benefits to an overwhelmed educational and therapeutic community, the diagnostic label of “autism”, and even the variability captured by the notion of “spectrum” disorders, does not offer clarity about “who” this child is, what is his/her unique profile, what are his/her strengths and difficulties, and what does the child and family most need from the health, mental health and educational systems. We MUST spend time with infants. children and families and when autism is being considered as a diagnosis, we must come to understand each child’s unique biological, sensory and regulatory profile, and come to understand the nature of the child’s core difficulties or differences. There is no “one” autism, and no “one” treatment. Emphasis on altering the behavior we “see” is inadequate. We must understand what each person’s behavior means, what purposes the behaviors serve, and respectfully honor the ways that children are trying best to interact with a world that is, for many, overwhelming and perplexing. Families also need our principled, thoughtful help and my concern about quick diagnoses, is that the comlexity of the experience and need for the child and family will be lost.
    Gerard Costa, Ph.D., Director and Senior Lecturer, Center for Autism and Early Childhood Mental Health, Montclair State University; Member, Board of Directors and Graduate School Faculty, Interdisciplinary Council on Developmental and Learning Disorders (ICDL)

  9. Mike the Psych says:

    Annee there are already fast and relatively accurate screeners for Autism, like the M-CHAT (which is probably the shortest out there aside from the original CHAT).

    Gerard makes some excellent points as well. I will add that although it is beneficial to identify Autism at an earlier age that doesn’t mean there will be supports and services available. I know in my area Early Intervention services (0-3 year olds) are very limited and often kids are on waiting lists for as long as a year to just see a Speech Language Pathologist, god forbid they need occupational or physical therapy. Simply being better at identification at a screening level or diagnostically does little if you cannot meet that individual’s needs.

  10. Mike the Psych says:

    Ann Murray you may want to visit Dr. Steven Novella’s blog (Neurologica) he has written quite a bit on the increase and possible reasoning to it.

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