Autistic spectrum disorders (ASD) present numerous challenges for early diagnosis and intervention. Recent research has concentrated on identifying symptoms of ASD in infants and toddlers. This article examines the feasibility of detecting ASD in infants and toddlers using early behaviors related to ASD and the impact that recent government policy changes and professional guidelines for family practitioners and pediatricians have had on early screening for young children with ASD. Empirical evidence from retrospective video analysis implies that ASD may be detected in infants and toddlers. Recent policy changes and guidelines for pediatricians and other practitioners recommend more intense efforts be made for developmental surveillance and referrals, but the impact of these policies on practice and on the lives of children with ASD and their families has been limited. Policy recommendations are made.
Keywords: [QQ: AU, PLS. ADD KEYWORDS]E arly intervention and detection of autism spectrum disorders (ASD) is currently a topic of much discussion. Everyone from academics to daytime talk show hosts is willing to take on this subject, give advice to parents, and advocate for children with ASD and their families. A search of the research literature for the terms autism and diagnosis for the year 2005 alone yields 167 hits using the PsycINFO database. Although there is clearly a great deal of discussion, two important questions remain: Can ASD be effectively detected in toddlers or infants? If it can, who is going to do the detection, evaluation, and intervention? This article integrates information from empirical research about detection of ASD, information about pediatric practices, and legislative policy in order to examine the issue in an interdisciplinary way and seek practical answers to the above questions. (For an exhaustive examination of research about symptoms of ASD in infants or toddlers, see Volkmar, Chawarska, and Klin, 2005, and for an excellent review of federal legislation related to ASD, see Turnbull, Wilcox, and Stowe, 2002.) We begin discussion of these issues with a brief primer on U.S. law as it relates to ASD, the education of children with disabilities, and early evaluation and intervention services. Then we discuss the prevalence and distribution of ASD in the United States. From there, we turn to a more detailed discussion of early detection of ASD, a brief discussion of the efficacy of early intervention for ASD, pediatrician practices relating to early detection, and the practical implications of developmental surveillance related to ASD. We conclude with practical and policy recommendations.