Autism is a common developmental
disorder, but it can be difficult to identify in a young child. Increasingly,
physicians have been called upon to perform routine autism screenings. All autism
spectrum disorders are defined by deficits in three core areas1:
- social skills
- behavior and interests
In 2000, a recent
practice parameter from the American Academy of Neurology, which was
supported by the American Academy of Pediatrics, called for the routine screening
of all children for autism.
"Autism is a common disorder of childhood. Yet, it often
remains unrecognized and undiagnosed until or after late preschool age because
appropriate tools for routine
developmental screening and screening specifically for autism have not been available.
Early identification of children with autism and intensive, early intervention
during the toddler and preschool years improves outcome for most young children
with autism.” (Abstract of Practice parameter: Screening and diagnosis of
autism. Neurology 2000, 55: 468-79.)
As stated above, routine screening is crucial because of autism’s prevalence,
the difficulty in diagnosing the disorder, and because children with autism who
receive early identification and intensive intervention have the best prognosis.
Despite these reasons and recommendations, most children are never screened for
autism. However, when a routine developmental screening raises concerns, or a
child is at risk of atypical development, an autism screening is imperative.
The term “autism” refers to a wide range of autism spectrum disorders,
from a child with “classic” autism who is non-verbal and asocial, to
a high-functioning child with idiosyncratic social skills, play, and language.
(Please see Autism Spectrum Disorders for a more detailed explanation of the
various clinical categories of autism.) All autism spectrum disorders are defined
by deficits in three core areas: social skills, communication, and behavior and
these deficits may be mild, autism can be difficult for a physician to identify,
especially without special training or within a busy medical practice.
The basic screening for autism is as simple as the disorder is complex, taking
less than five minutes. There are a variety of screening tools for autism, but
they share a common goal. An autism screening enables a physician to target the
three core areas of the disorder through a combination of observation and interaction.
(For more information about autism screening tools, including examples, please
see the Screening Tools section.)
1 Core deficit areas for Autism are drawn from the Diagnostic and Statistical
Manual of Mental Disorders (4th ed., pp. 70-71) Washington, DC: American Psychiatric
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