- New guidelines from the American Academy of Pediatrics recommend screening for autism spectrum disorder at the ages of 9 months, 18 months, and 24 months.
- The organization recommends evidence-based intervention treatments as early as possible.
- Experts say providing therapies for autism at an early age produces the best outcome for children with the condition.
Autism spectrum disorder diagnosis rates have skyrocketed in the United States since 2000, from 1 in 150 in 2000 to 1 in 59 today, according to the
That’s largely because physicians have become better at recognizing and diagnosing autism spectrum disorder.
With that knowledge has also come a better understanding of how to help autistic people live full lives in their communities.
That assistance should start at a young age, states the American Academy of Pediatrics (AAP) in an updated report on how doctors should evaluate and advise families of children with autism.
The report, which was published today in the journal Pediatrics, is the AAP’s first update report on autism recommendations since 2007.
Here are a few of their key recommendations:
- Developmental and behavioral screenings at the 9-month, 18-month, and 30-month visits as well as standardized screening of children for autism spectrum disorder at 18 and 24 months old.
- Help children with autism spectrum disorder in accessing holistic evidence-based care that addresses social, academic, and behavioral needs, including mental healthcare.
- Help families and youth develop a transition plan into adulthood.
- Educate individuals as well as families about why these interventions work, and connect these families to supportive organizations and resources.
“We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes,” said Dr. Susan L. Hyman, a professor in the department of pediatrics at the University of Rochester Medical Center in New York and a lead study author who wrote about the research in collaboration with the AAP Council on Children with Disabilities and the AAP Section on Developmental and Behavioral Pediatrics.
One of the elements the updated report singles out is a greater medical understanding of the kinds of co-occurring conditions that typically occur alongside an autism diagnosis.
Intellectual disabilities, language disorders, ADHD, anxiety, trouble eating and sleeping, gastrointestinal symptoms, and seizures are just a few common co-occurring conditions, according to the report.
Of these, 4 in 10 people with autism spectrum disorder have some kind of intellectual disability, and as many as 6 in 10 have anxiety conditions.
“There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies,” Hyman told Healthline. “Interventions work best when they are early, when they are intense, and when they involve the family.”
Allison Bruning, principal of Academic Warriors, an online school for autistic, gifted, and special needs students, agrees.
“Obtaining a diagnosis of autism can be hard for many families,” she told Healthline. “Because it is a spectrum disorder, not every child is going to display the same symptoms, and the degree of the symptoms can vary from child to child.”
Bruning herself received an autism spectrum disorder diagnosis later in life.
“I struggled as a child with making social relations. Many times, when placed in a social situation, I would try too hard to make friends,” she said. “I also have a hard time reading facial expressions and knowing when someone tells me something that is a joke or a lie.”
Early intervention would have helped.
“Early diagnosis and intervention are critical to maximizing long-term skill gains and closing gaps between a child receiving a diagnosis and a same-aged peer,” said Chris King, BCBA, clinical manager and a board-certified behavior analyst at Eastern Michigan University’s Autism Collaborative Center.
“When diagnosis and treatment happen later in childhood, the more time the child has had to use less preferred means to get their needs met, such as aggressive behaviors,” King told Healthline. “Early detection allows therapy providers the ability to teach a child skills in a more socially appropriate or functional way.”
Another aspect that’s critically important is getting care specific to autism spectrum disorder, says Diana L. Robins, PhD, director of the A.J. Drexel Autism Institute at Drexel University in Philadelphia.
“Although the AAP report accurately points out that many early intervention agencies do not require a diagnosis in order to begin treatment, most often the services offered prior to an autism diagnosis are low intensity and not specific to autism,” Robins told Healthline.
“Research has not demonstrated that low intensity, general intervention (e.g., speech therapy) impacts outcomes for children with an autism spectrum disorder. Therefore, it is of the utmost importance to identify children with autism as young as possible, to begin autism treatment earlier,” she said.
Recommending care is one thing. Accessing it and being able to afford it is another, the study authors reported.
“Communities should build services to promote social skills appropriate for work and postsecondary education, access to appropriate medical and behavioral health services, job skills development, and community leisure opportunities,” the authors wrote.
In addition, “pediatricians need to engage with families and youth to plan a transition to adult medical and behavioral health care,” the researchers said.
“There need to be more equitable and affordable therapies for all families, from the time of diagnosis through employment and adult life,” Hyman said in an AAP press release. “All children deserve options and hope for productive, satisfying lives.”
In the meantime, families can obtain resources for children (and young adults) with developmental conditions through the Individuals with Disabilities Education Act (IDEA).
“Once children are diagnosed with autism (and in some regions even a provisional diagnosis based on screening is accepted), parents should ask for intensive behavioral intervention, provided by therapists trained in autism treatment,” Robins said.