Early Autism Detection: Are We Ready for Routine Screening?

Abstract

BACKGROUND. Autism is a serious neurodevelopmental disorder that has a reportedly rising prevalence rate. The American Academy of Pediatrics recommends that screening for autism be incorporated into routine practice. It is important to consider the pros and cons of conducting autism screening as part of routine practice and its implications on the community. We have explored this question in the context of screening from a scientific point of view. METHOD: A literature search was conducted to assess the effectiveness of community screening programs for autism. RESULTS: Judged against critical questions about autism, screening programs failed to fulfill most criteria. Good screening tools and efficacious treatment are lacking, and there is no evidence yet that such a program would do more good than harm. CONCLUSIONS: On the basis of the available research, we believe that we do not have enough sound evidence to support the implementation of a routine population-based screening program for autism. Ongoing research in this field is certainly needed, including the development of excellent screening instruments and demonstrating with clinical trials that such programs work and do more good than harm.

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

“…Some scientists and practitioners have questioned whether the evidence relative to general developmental surveillance warrants ASD screening, 7,8 and others have argued that research needs to move beyond risk classification and evaluate longer term outcomes of ASD screening (eg, impact on age of diagnosis, related gains attributable to earlier enrollment in intervention). 9 The uptake of ASD screening into pediatric practice has been modest.…”

Sensory and Motor Behaviors of Infant Siblings of Children With and Without Autism

“…The American Academy of Pediatrics Council on Children with Disabilities (2006) recommended that pediatricians incorporate autism screening as part of routine practice. However, Al-Qabandi, Gorter, and Rosenbaum (2011) reported that routine screening of all infants may be premature at this time because of a lack of effective screening tools and evidence-based, efficacious practices and because of the need for a cost-benefit analysis of conducting universal early screenings.…”

Autism and Pediatric Practice: Toward a Medical Home

“…However reasonable it seems to include standardized instruments for screening for ASD into well child care, the barriers include the accuracy of existing validated instruments (Al-Qabandi et al 2011), the time necessary for screening, the cost of screening, the comfort of the care provider in referrals and management of children with ASD prior to diagnostic referral, and referral resources for diagnosis and treatment in the community (Dosreis et al 2006;Gura et al 2011). Surveillance alone is inaccurate in early identification of autism.…”