Pediatricians Get New Guidance On Autism
For the first time in over a decade, the nation’s pediatricians are getting updated clinical recommendations on treating children with autism.
A report issued Monday by the American Academy of Pediatrics “reflects significant changes in the field” since recommendations were last published in 2007, the group said.
The guidance accounts for a greater understanding of autism, the conditions that often occur alongside it and the growing body of research supporting evidence-based interventions for the developmental disorder, according to those behind the new report.
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The pediatrics group recommends developmental and behavioral surveillance at every well-child doctor visit. In addition, kids should undergo developmental screening at 9, 18 and 30 months as well as autism-specific screening at 18 and 24 months, according to the guidance.
Autism can be diagnosed as early as 18 months, the American Academy of Pediatrics said. However, the group notes that an official diagnosis is not needed in order to get help if there are concerns.
“We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes,” said Susan L. Hyman, a developmental and behavioral pediatrician at the University of Rochester and the lead author of the autism report. “There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies.”
Beyond early intervention, families should be offered a genetic evaluation and pediatricians are advised to look for co-occurring conditions in children who have autism. Between 40 and 60 percent of those on the spectrum are reported to have anxiety disorders and 40 percent have intellectual disability, the American Academy of Pediatrics said. Other common issues include language disorders, attention deficit hyperactivity disorder, sleep problems, feeding issues, gastrointestinal symptoms and seizures.
The guidance encourages pediatricians to ensure that children with autism have access to evidence-based services at home and school, refer families to possible clinical trials and support organizations and assist with the transition to the adult health care system.
Separate clinical guidance also released Monday from the pediatrics group related to developmental disorders more broadly is emphasizing the importance of universal screening for developmental delays.
“Through comprehensive screenings, we hope to identify problem areas and missed milestones before a child turns 3,” said Paul H. Lipkin of the Kennedy Krieger Institute and the Johns Hopkins University School of Medicine and the lead author of the clinical report on developmental surveillance. “With continued surveillance, early learning and attention problems often become more apparent by age 4 or 5. The earlier we can address these problems, the better.”
Developmental surveillance should continue at every well-child visit thorough adolescence, the guidance says.
Children found to be at risk for developmental issues should be referred to early intervention or special education services and have thorough developmental and medical evaluations, according to the pediatrics group.