Multipronged Approach Needed for Earlier Autism Detection

Although the available methods for identifying autism are improving, a “multipronged approach” is needed to diagnose the developmental disorder earlier, according to a study published in the February 2014 issue of Journal of the American Academy of Child & Adolescent Psychiatry.

Amy M. Daniels and her colleagues at Autism Speaks analyzed 40 studies outlining 35 different autism diagnostic methods, which were grouped into the categories of “awareness (n = 4), routine screening (n = 21), and practice improvement to enhance screening (n = 10).”

According to the investigators, the awareness approaches “were associated with positive changes in knowledge of autism-related topics,” routine screening methods “yielded high or increased rates of screening and referrals,” and practice improvement tactics “resulted in increased screening and referral rates and highlighted the importance of adopting a multipronged approach to enhance early detection.”

However, the researchers said few studies “assessed the effect of screening on age at diagnosis or services enrollment,” so they relented “the effectiveness of such efforts on reducing time to diagnosis and services enrollment remains largely untested.” In addition, the authors believed the lack of outcomes “beyond rates of referral indicates the need for enhanced methodological rigor, particularly with respect to length of follow-up and quality of measures used.”

Throughout the study, the researchers stressed the importance of early autism detection. According to a press release from Autism Speaks, the average autism patient is diagnosed at 4 years of age, even though it is possible for them to be diagnosed as early as 24 months of age. As a late diagnosis can provide many setbacks for those with autism, the statement said “early intervention is crucial for enhancing the development of communication, learning and social skills in children with autism.”

The study’s findings call attention to the importance of access to specialists at an early age, since it found many children suspected of having autism were not referred to a specialist for a thorough evaluation. In the press release, Daniels pondered the lack of follow-up for children presumed to have a high risk for developing autism.

“Are pediatricians advising parents to take a wait-and-see approach? If so, that’s a concern, because the sooner children get treatment, the better their outcomes,” Daniels said.

According to the press release, other barriers to early autism intervention may include “community shortages of specialists who can perform diagnostic evaluations and of appropriate therapy programs available.” Nevertheless, Daniels said “the good news is that we found universal screening for autism risk to be feasible and practical, (and) we also see that it seems to work best in the context of a toddler’s well-child visits to a pediatrician or family doctor.”