Should Every Child Be Tested for Autism Spectrum Disorder?

Autism Spectrum Disorder: Should Every Child Be Screened?

For several years, most pediatricians have been following guidelines created by medical experts that suggest all children between the ages of 18 and 24 months be screened for an autism spectrum disorder (ASD) – even if the parents aren’t worried about development or behavior.

Recently, another expert panel suggested that the guidelines should be changed so that pediatricians screen for autism only if the parents are actively concerned. The panel said that there wasn’t enough evidence to show that screening every child can ultimately make a difference and may only find kids with mild autism.

But I, and other ASD specialists, believe that routine screening for autism should continue for all children. That’s because early detection and intervention can make a big difference in the lives of kids – even those with mild cases – and sometimes parents and even physicians can miss clues to a potential problem.

The screening is easy– and necessary. No matter how good your pediatrician is, research shows that many won’t catch developmental delays during a routine health visit. The screening will walk you through a series of simple questions about how your child behaves, communicates and interacts with things and people. Right now there are racial and socioeconomic disparities surrounding autism diagnosis and access to services. A standardized screening for ASD has the potential to reduce much of that and get kids the treatment they need.

Diagnosing autism is a process. The initial screening will not confirm a diagnosis of autism, but will put you and your child on a “watch and wait” schedule. If your child continues to miss developmental milestones, then you and your child’s physician will have a plan of action in place to get your toddler the treatment they need without delays. We know if treatment starts early, your child’s chances at improvement are much better.

Watch for signs. Ask your pediatrician for a developmental checklist. Visit the Nationwide Children’s Child Development Center website for more information about developmental milestones and screening. Listen to your gut if you have any concerns about your child’s behavior or development, and mention it to your pediatrician.

Practice guidelines like those for autism screening are updated from time to time as information and technology change, and it can be confusing for parents when medical experts do a reversal. But the need for routine autism screening isn’t confusing – it’s simple for you, your child and your physician. If your pediatrician hasn’t already screened your toddler for autism, ask for it!

Daniel Coury, MD
Daniel L. Coury, MD, is Chief of the Section of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital and a Professor of Clinical Pediatrics and Psychiatry at The Ohio State University College of Medicine. Dr. Coury received his medical degree from the University of Tennessee Center for Health Sciences, followed by an internship and residency in pediatrics at the University of Tennessee Center for Health Sciences. He was a fellow in ambulatory pediatrics at Brown University. Activities over the past two decades include federally funded projects in the areas of drug exposed infants, training in developmental and behavioral pediatrics, pediatric residency curriculum guidelines, pediatric psychopharmacology, training professionals in dual diagnosis and the establishment of a web site for developmental and behavioral pediatrics. He also is active in conducting pediatric psychopharmacology clinical trials. Dr. Coury’s research interests include developmental and behavioral pediatrics, medical education, attention deficit hyperactivity disorder and autism. In addition to his duties as Section Chief, he is the Administrative Medical Director for Nationwide Children’s Hospital Behavioral Health Services and is Medical Director of The Autism Treatment Network of Autism Speaks.

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