In the weeks right before my son Liam's two-year-old well-child check-up, I did everything in my power to dispel my gut feeling that he was autistic. Liam had already seen several doctors who missed early autistic indicators, but in the end, he was diagnosed with severe autism – though it took two years and a bevy of teachers and therapists to help me put all the signs together.
A new study published online in Pediatrics finds that short check-ups aren't enough for doctors to spot the signs of autism in many young children. Kids with autism can show both typical and atypical traits at an early age, so a speedy check-up can actually cause doctors to miss certain signs. "With only a few atypical behaviors, and many more typical behaviors observed, we suspect that the predominance of typical behavior [in a short visit] may be influencing referral decisions, even when atypical behavior is present," said Terisa Gabrielsen, lead author of the study.
To determine whether the typical 10 to 20-minute well-child check-ups was enough time for doctors to notice autism symptoms, researchers from the University of Utah tested 42 kids (ages 15 to 33 months) for autism. They created two 10-minute videos showing various typical and atypical behaviors, and asked two psychologists who specialized in autism to view the videos. They were asked to evaluate the kids who needed further referrals. What the psychologists didn't know was that 14 kids were already diagnosed with autism, 14 had possible language delays, and 14 did not have autism. HealthDay reports:
About 11 percent of the autistic children's video clips showed atypical behavior, compared to 2 percent of the typically developing children's video clips. But that meant 89 percent of the behavior seen among the children with autism was noted as typical, the study authors noted.
When the autism experts picked out who they thought should be referred for an autism assessment, they missed 39 percent of the children with autism, the researchers found.
The study's results haven't surprised professionals in the autism community, but they do highlight an important truth: when it comes to diagnosing autism, time is of the essence. According to the American Academy of Pediatrics, all children should be evaluated for autism between the ages of 18 and 24 months. A diagnosis before age two and the accompanying Early Intervention therapies—including speech, occupational, and behavioral therapies—have proven most effective in helping autistic children reach their potentials.
Although Liam started early intervention therapies just after his third birthday, he could have gotten a diagnosis sooner if I had mentioned his other peculiarities during his quick 2-year-old check-up: he didn't smile as a baby, he never slept through the night, he screamed when left alone with anyone but my husband and me, he often spaced out and didn't respond to his name, and he didn't play with toys. I know now that these are clear signs of autism, but back then I didn't want to take up the doctor's time, and I wasn't sure how to communicate my fears over his usual "hey kiddo" banter. Our lack of communication made my boy lose precious time, and he didn't get the help he needed for months.
If you have concerns that your child may have autism, educate yourself on the signs, observe your child, and speak up during check-ups. Don't be afraid to take up your pediatrician's time and ask questions. Believe me, you'll be glad you did.
Jamie Pacton lives near Lake Michigan where she drinks loads of coffee, dreams of sailing, and enjoys each day with her husband and two sons, Liam (6) and Eliot (4). Her writing has appeared in the Autism and Asperger's Digest (2011-2013), Parents, and the book collection Monday Coffee and Other Stories of Parenting Kids with Special Needs. Find her at www.jamiepacton.com, Facebook (Jamie Pacton), and Twitter (@jamiepacton).
Early Signs of Autism
Image: Baby and Doctor via Shutterstock