As a member of the medical field, and the parent of two adult children with Aspergers, I think it's fair to say that most of us know something of autism. We know that it is a cluster or spectrum of symptoms, including verbal, social, and intellectual impairments stemming from differences in the brain and/or a genetic condition. We know that autism can result in capabilities that range from those with severe challenges to those with remarkable cognitive gifts. Most of us may even know that April is Autism Awareness month.
What you may not know
The American Academy of Pediatrics recommends that 100 percent of children be screened for ASD by the age of 18 months, yet the CDC estimates that less than 20 percent are completed for children 5 years and younger.
Autism Spectrum Disorder (ASD) now includes autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome; conditions that used to be diagnosed independently. Autism is far from a static, hopeless diagnosis, but early screening and intervention are the key to improving future prospects for children with ASD.
As Dr. Michael E. Kelley, the executive director of The Scott Center for Autism Treatment at the Florida Institute of Technology stated, "If we can get our hands on kids before elementary school, 50 percent will be indistinguishable from their peers by the time they enter school - and most of the remaining 50 percent will also show significant improvement. Without early intervention, only 2 percent will show such improvements. Unfortunately, only 19.5 percent of children are screened by age four, so a lot of these kids aren't going to get the services early enough to make a significant impact."
So, what is the best age to start screening for autism?
The American Academy of Pediatrics (AAP) recommends pediatricians screen all children for developmental disabilities using a standardized screening tool during routine 9-month, 18-month, and 24-month wellness checks. Dr. Ivy Chong, director of Autism Services and Training at the Scott Center recommends the Ages and Stages Questionnaire (ASQ) as the best evidence-based tool for developmental milestone screening. If a social or emotional delay is suspected, the Modified Checklist for Autism in Toddlers (MCHAT) screener should also be used.
Chong said that, "Parents will report that their child doesn't respond to their own name or to sounds, that they don't like to be held, or they're not smiling. Clearly these are red flags at as early as 6 months, not just of ASD, but potentially other developmental disorders as well."
According to the CDC's website, parents' concerns are generally valid and are predictive of developmental delays. Research has shown that parental concerns detect 70-80 percent of children with disabilities.
Chong continued, "Primary care providers often do not give enough credit to parents reporting these concerns. Parents are told to wait until the child is two years old or worse, until they go to school. When these early warning signs are ignored, parents often feel bewildered and frustrated by their child's behavior." Parents who suspect or wish to rule out that their child may have a disorder should be encouraged to request screening procedures at any time from their pediatrician.
For pediatricians seeking to refer parents to evidenced-based treatment organizations, The Scott Center for Autism Treatment located in Melbourne, Florida, is unique. It offers an innovative telehealth option for consultation, diagnosis, and intervention. By utilizing telehealth services, "we can overcome the constraints of traditional approaches (onsite clinic) and still provide the screening, diagnosis, care planning, intervention and parent training for children experiencing social and emotional delays," said Chong. In addition, this spring, the center will be launching an online screening bundle that will help providers and parents with personalized diagnosis, therapeutics, and educational materials.
Parents and children come from around the world to The Scott Center for the most advanced Applied Behavior Analysis (ABA) autism treatment methods available, and it ranks among the best in the world for its research contributions to the field of behavior analysis. The Scott Center is also actively involved in clinical research, constantly contributing to the body of literature on autism.
"We are also actively training practitioners in telemedicine techniques and developing new, empirically proven protocols for ASD treatment that can be delivered via telemedicine," said Kelly.
Although it can be a difficult and long journey, the future for children with autism is getting brighter. Innovative therapies and services are shaping the treatment landscape around us, and it's heartening to see how far we have come in just the last 10 years. With that being said, as the parent of two children with ASD, I know we as a medical community can do better.
We can always lead parents to places like The Scott Center at FIT for evidence-based treatment and resources. If we want to give children with autism the best chance at living a fully-realized, fulfilling life, we need to commit ourselves to early diagnosis and intervention. We need to find creative ways to ensure that every child is screened at their wellness checks, or as soon as a parent expresses concern. The healthcare community as a whole needs to accept and encourage a mantra of early screening and intervention.
The missing link in the early intervention of autism is you, the provider. What will you do to make a difference?
Beth Rudloff is the Chief Innovation Officer for MedSpeaks in Orlando. She can be reached at firstname.lastname@example.org.
For more information, visit AutismAdvisor.org, call 321-674-8106, or email Boyd Mark, Director of Telehealth at email@example.com.