Friday, November 9, 2007

American Academy of Pediatrics Releases Autism Reports Urging Early Screening

Two reports released by American Academy of Pediatrics (AAP) reveal good news to those of us in the autism community who are working to provide education, advocacy, and support to families and individuals who have Autism Spectrum Disorder (ASD). The first report is titled "Identification and Evaluation of Children with Autism Spectrum Disorders." According the news release from the AAP, the authors reviews the "subtle early signs" of autism and advises pediatricians to know the signs of various developmental disorders and to ask caregivers if they have any concerns about the development or behavior of their charges during Well Child Visits.

The AAP news release also discusses a second report which is titled “Management of Children with Autism Spectrum Disorders." This report discusses the importance of early intervention and how it is crucial for the effective treatment of children with ASD. The report also strongly advises intervention as soon as the ASD diagnosis is seriously considered rather than deferring until a definitive diagnosis is made.

Although I did not get to read the entire reports because direct online access was blocked on the AAP's website, I am still delighted with the news that these reports exist. Based on the descriptions of these reports, I believe that the authors offer pediatricians (and hopefully family doctors who treat young patients) excellent advice. I particularly am happy with the author's advice (in the second report) to consider suggesting early intervention (a hodge-podge of various therapies and early education) as soon as the ASD diagnosis is considered rather than waiting until a definitive diagnosis is made.

In my family's case, our oldest child was six before a Developmental-Behavioral pediatrician made the definitive ASD diagnosis. (We had to wait eighteen months for an appointment.) A four-person Autism Impairment (AI) team, working within our school system, observed my son (then in an early education class) for a total of 80 hours (20 hours per team member.) The team then gave our son the AI label. He was five years old. My son's pediatrician considered the ASD diagnosis slightly before the AI team did their work.

Five years ago, I noticed it was the school system which prescribed the first official early intervention program for my son and that it was the school system which provided more help. Because of my son's diagnosis history, it wasn't too difficult for me to conclude that the medical community is behind when it comes to the diagnosis and treatment of autism. In my opinion, schools (at least some school systems anyway) are way ahead in the game.

This is especially true when it comes to identifying ASD and helping young children on the spectrum. Pediatrician's might have a clue about ASD, but family doctors in particular may have difficulty in spotting the signs (especially the early signs listed in first report) and suggesting treatment. This opinion is coming directly from my own experience with the whole diagnostic process.

When we first started having concerns about our son's development, our then family doctor (in Lansing, MI) seemed to have no idea what was going on with my son. I don't think he was aware of the signs of autism. Instead, when I brought my son into the doctor's office at age three-and-a-half, the doctor suggested I take him to a developmental psychiatrist. I might of done this, but the appointment and screening would have cost us $1,000 with insurance only covering $400. Facing the overwhelming cost of a $600 fee, we said "no thanks."

When we moved to Mt. Pleasant, MI for my husband's new job when our son was four-and-and-a half, I decided that maybe I better take my two children to a pediatrician instead of a family doctor. I had other medical-related concerns for my older son. These concerns included a delay in physical growth as well as developmental growth. (Just before we moved from the Lansing area an endocrinologist determined my son had the bone growth of a two year old--a delay of about two-and-a-half years.)

Before we moved, I realized that I should take my child to see a pediatrician rather than a family doctor. Seeing a family doctor had been good enough for my husband and I when we were growing up, but I was coming to realize that my son had special needs that probably would be best addressed by a pediatrician. I hoped that our son's new doctor would zone in on what was going on developmentally. She listened closely to what I had to say and then handed me some screening papers for autism.

I scoffed at the idea of my son having ASD, but as I scanned the questionnaire I started to face the reality that my son does indeed have high functioning autism. By this time a regular preschool teacher had already helped us get screening from the school system. This screening resulted in my son being placed in a special education preschool class three months months before we moved.

My point is that if my family doctor had the screening tools and the prompting to screen all children for autism, my son might have had early intervention at least a year earlier. He's doing well now, but who knows how much better off he would have been with an extra year or so of help.

My thanks goes out to the authors of these report on behalf of all families who are in need of a diagnosis and early intervention. My biggest hope is that family doctors take note of these reports as they seem to be in need of advice when diagnosing and treating ASD.

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