Doctors Urge Early Screening for Autism

Oct 29, 10:50 PM

Current Headlines: MELVILLE, N.Y. _ Parents of children diagnosed with autism and related conditions say new guidelines urging screening for all children twice by age 2 is a step in the right direction _ but remains a long way from providing answers about a perplexing spectrum of disorders.

In San Francisco Monday, two clinical reports presented at the annual meeting of the American Academy of Pediatrics underscored the nation's growing problem with autism, which now is believed to affect one in every 150 children in the country.

The new guidelines provide detailed information on the "signs and symptoms" of autism spectrum disorders, conditions that range from neurodevelopmental and language delays to Asperger's syndrome, which is often typified by an extraordinarily high IQ.

Dr. Susan L. Hyman, a member of the academy's expert panel on autism, said language delays are usually the first symptom prompting parents to seek medical advice. But she and other experts believe there are earlier, subtler signs _ sometimes evident around the age of 18 months _ that may raise parental concerns sooner. Hyman, an associate professor at the University of Rochester, doesn't think the new guidelines will change the rapport between pediatricians and parents.

"Historically, one of our biggest jobs has been to reassure parents because there is such a wide range of normal development," she said. But she believes the guidelines will help pediatricians counsel parents.

The new rules call for "universal screening" between 18 and 24 months, using uniform screening nationwide. Having the screening done twice will better aid families, experts say.

Some parents think the guidelines do not go far enough to help parents understand autism's complexities.

Evelyn Ain of Oyster Bay, N.Y., the mother of 7-year-old Matthew, who has an autism-related condition, said the new approach could lead to excessive diagnoses. "I think it's a very good idea, but I am very concerned about why they're doing it," said Ain, editor of Spectrum, a magazine she founded for parents of children with autism. "What kind of training and experience do pediatricians have, looking for autism or anything to do with developmental delays?

"I think they're trying to put a Band-Aid on a very big problem."

Robert Krakow, of Garden City, N.Y., who has an 8-year-old son whose doctors have diagnosed autism, underscored that "the autism label is something that gets in the way." However, he said the guidelines draw a needed spotlight to a growing medical issue.

Megan Concannon, a Bay Shore, N.Y., mother, has a 5-year-old who has been diagnosed with an autism-related condition.

"Now that they are on board," Concannon said of pediatricians, "perhaps they will work with families in finding the cause and finding a cure for autism. They also need to be open to the very real possibility that autism is not simply a psychiatric disorder."

Dr. Melissa Nishawala, of New York University's Child Study Center, said many parents have long been at odds with doctors about treating autism. She added that the new guidelines do not support wheat- and milk-product-free diets, an approach taken by many parents who say the dietary regimen helps their children.

Dr. Joel Bregman, medical director of the Fay J. Linder Center for Autism, applauded the academy's effort to spot autism earlier. "I have seen a preliminary version. They look quite good to me," Bregman said. He said it should not frighten parents to be aware of early signs.

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