Early Screening For Autism: Moving Forward, Not Backward
Last week a review paper published in Pediatrics suggested that there is insufficient evidence to support routine screening for autism in toddlers. While this paper — which is a conceptual piece based on literature review and not a scientific study per se — points out a number of legitimate challenges in screening for autism, the conclusion goes against the current tide of thinking which emphasizes the importance of early identification, particularly in toddlerhood. As such, my impression is that the conclusion of this paper moves our thinking backward, rather than forward.
One of the biggest changes in parenting advice in recent years has been shifting from the “wait and see” approach to “learn the signs and act early.” The idea is to help parents learn about the most important developmental milestones and to be aware of potential signals of problem areas — so that they can work with their pediatrician to track development and determine if and when intervention would be productive. Why? Simply put, early intervention is more likely to have the most pronounced long-term effects on development.
One of the most exciting areas of research on autism focuses on testing new methods for early identification and intervention. The organization Autism Speaks — which supports all kinds of cutting-edge science — nicely summarizes the idea that we should be promoting more screening and improvements in that process rather than less screening, especially as recent studies demonstrate the potential for early intervention to have meaningful effects on development.
As a scientist, I understand that we need to bring a critical eye to our current knowledge base and practices. That said, I also appreciate that we have a public service to not only maintain momentum in research and practice, but to accelerate it when we are talking about developmental disorders such as autism. Discouraging screening for autism runs contrary to the mission of keeping parents as informed as possible about their children’s development, and also could inhibit the critical partnership between parents and pediatricians.
It is certainly true that the current screening for autism is far from an exact science. And I agree that any efforts to improve this process should be a priority for research and clinical practice. But the reality is that we need to serve parents today as we continue to improve our future efforts. Let’s keep moving forward.
Add a Comment