Physician's First Watch, October 30, 2007


[Rachel's introduction: Because autism spectrum disorder may now be affecting nearly one in every 50 boys in the U.S., the American Academy of Pediatrics urges a precautionary approach to autism -- universal screening even when there is no reason to suspect the disorder will be detected.]

All children should be formally screened for autism at 18 and 24 months, even if there's no reason to suspect the disorder, according to new guidelines from the American Academy of Pediatrics.

A clinical report, "Identification and Evaluation of Children With Autism Spectrum Disorders," was released by the academy online. It notes several red flags that call for immediate evaluation:

** lack of babbling, pointing, or gesturing by 12 months

** no words by 16 months

** no spontaneous two-word phrases by 24 months

** regression of language or social skills

Physicians are encouraged to look for signs of autism at every well- child visit and to ask parents open-ended questions about developmental concerns, such as a child not responding to his or her name. The report also provides an algorithm for screening children for autism. The AAP says early diagnosis will help "guide families to effective interventions, which will ultimately improve the lives of children with [autism spectrum disorders] and their families."

A second report, "Management of Children With Autism Spectrum Disorders," reviews therapies and educational strategies. Both reports will appear in the November issue of Pediatrics.

AAP report on identification and evaluation (Free PDF)

AAP report on autism management (Free PDF)

AAP press release (Free)

Associated Press story (Free)

Helpful autism education site for parents (Free)