April 28, 2011
By Autism Society
By Lauran Neergaard
AP Medical Writer
A simple checklist that parents fill out in the waiting room may help doctors someday screen for warning signs of autism as early as a baby's first birthday.
San Diego pediatricians tested the tool with more than 10,000 babies at their 1-year checkups, looking for such things as how the tots babble, gesture and interact with others.
The research, being published Thursday, is a first step in the quest for earlier autism screening. It's not ready for routine use, as more work is needed to verify its accuracy. But it also may prove valuable in finding more at-risk babies to study what causes the developmental disorder.
"There are subtle signs of autism at one year if you just look for them," said neuroscientist Karen Pierce of the University of California, San Diego, who led the study. "Let's just get these kids detected early and treated early."
Recent data suggest about 1 in 100 U.S. children has some form of autism, which ranges from mild to severe problems with behavior, communication and socialization. The American Academy of Pediatrics already urges autism screening during regular doctor visits at ages 18 months and 24 months. Yet a 2009 study found that on average, children aren't diagnosed until they're 5.
Experts say early therapy can lessen autism's severity, even if they don't know exactly what types will prove best. "The earlier you start, the better," said Dr. Lisa Gilotty of the National Institute of Mental Health, which helped fund the study.
Hence the interest in younger screening.
"This is very exciting work, to think we may be able to identify children with autism this early," said Dr. Susan Hyman of the University of Rochester and a pediatrics academy autism specialist, who wasn't involved in the new study.
But, she cautioned, it's not clear how best to do that: "I don't think screening for autism at 12 months is ready for prime time."
Thursday's study uses a 24-question checklist written in easy-to-understand terms that parents can answer in about five minutes. It was developed a few years ago to detect broader signs of language or developmental delays. Pierce signed up 137 pediatricians to use the questionnaire during every 1-year checkup and refer babies who failed for further testing. Those youngsters were re-evaluated every six months to age 3, when a diagnosis could be certain.
Of 10,479 babies screened, 184 who were sent for further testing followed through -- and 32 eventually were diagnosed with autism, Pierce reported Thursday in the Journal of Pediatrics.
That's consistent with expected rates of detection that young; Rochester's Hyman said some forms of autism don't become apparent until age 2 or even later.
Numerous other children were diagnosed with language delay or some other developmental problems, so that in the end, the screening accurately predicted some problem in 75 percent of those kids, Pierce calculated. But there were false alarms for 1 in 4, who had no problems.
The children began treatment at around 19 months. In addition, Pierce's program does MRI scans and other tests as part of broader research into autism's biological underpinnings, studies now limited by the few numbers of babies being identified as at risk when they're so young.
One big puzzle: Only a fraction of the total 1,318 babies who failed the initial screening were referred for follow-up. The study couldn't tell how much of that gap was recording error, or if doctors or parents weren't worried enough to follow up right away, or if families went elsewhere.
Still, the study shows early screening is feasible in the hectic everyday offices of regular pediatricians. That's important as scientists now develop various screening tests, said Geraldine Dawson, chief science officer of Autism Speaks, which co-funded the work.
Pierce says other cities should consider the screening -- but doctors first must know where to send families for follow-up testing. That can cost several thousand dollars, and state programs for free evaluation of at-risk children may have waiting lists.
For now, what should worry parents? Pierce's top concerns:
--Lack of what she calls "shared attention." Around age 1, babies should try to "pull your attention into their world," pointing to a bird and watching to see if you look, for example, or bringing you a toy, she said.
--Lack of shared enjoyment, where a baby may smile at mom but not engage if other people try peek-a-boo.
--Repetitive behaviors like spinning a car wheel rather than playing with the toy.
Language delays are worrisome if they accompany other problem signs, she said: "If they wave and they point, that's a good sign the brain is readying itself to be ready to speak."
(Source)
Topics:News
Comments
Please login or register before you comment. Click here to login or register.
Submitted by: Brain Balance Date: April 29, 2011
Early intervention is so important and can help at-risk children get the care they need as quickly as possible. A properly functioning brain communicates between and within both hemispheres at lightning speed. A functional disconnection in this communication is the root of all types of neurobehavioral and learning problems including ADHD and autism. At Brain Balance™, we custom design physical and cognitive activity plans to establish proper connections and improve rhythm and timing. Visit our website to learn more! http://www.brainbalancecenters.com
At 1 year I knew something was wrong with my son. He didn't babble, he didn't turn when you called his name, he didn't point, he didn't play with his cars - he lined them up and spun their wheels, he rocked for hours, and he had sensory overload meltdowns 4-5 times a day. By 14 months we had checked his hearing and he was evaluated by an Early Intervention specialist. As I watched, I thought to myself "OMG, he's autistic." By 18 months he was officially diagnosed and in early intervention. The prognosis was lousy. He didn't become verbal til he was 4. Now, in 8th grade he's in the top of his class, has wonderful friends and even had girlfriends. Early intervention and dedicated, focused people can do wonders for autistic kids.
my son was diagnosed at 2 and a half. i noticed at 2 he started losing speech and eye contact, but before at 15 and 18 months he babbled and said momma and had good eye contact. its as if a window was slowly closing and he lost some of these things he was previously doing. i think he did not develop it until 2
As a special ed teacher with 16 AU students on my caseload in a mainstreamed school, I love that there are new ways of early identification! The earlier the better! The biggest problem I see is getting some parents to realize there is a problem and get out of the denial phase for the sake of their children!
My son was diagnosed at 2. Thanks to my wonderful sister and a new ped. His regular ped. Said nothing was wrong with him he was just a brat!! After hours of research by my sister we found a wonderful new ped. And within 10 min of meeting her she sent us out for screening. = was so thankful to finally have answers. My son is 5 now. he has received PT OT DT and ST. He only gets the speech therapy now. He will be starting school next year with everyone else! Early intervention is the best answer for these poor kids! Never let someone tell you there is nothing wrong! You are that childs parent and you know them best!
EARLY INTERVENTION is the key!!! My son was officially diagnosed at age 3 but could have been diagnosed as early as 18 months had i listened to one very astute physician who said that he noticed autistic characteristics in my son. Fortunately my son was already enrolled in a special preschool and an early childhood intervention program.He was officially diagnosed at age 3. At age 13, the diagnosis was revised to Asperger's syndrome. I do believe that early and consistent intervention has made all the difference in my son's independent functioning today as a 24 year old young man. Throughout his preschool and school years he rec'd PT OT ST and adaptive PE. He also rec'd sensory integration and auditory training plus play therapy when he was quite young. He was mainstreamed throughout his education with use of resource room for testing purposes and his most difficult subject - math. He rec'd his high school diploma on time with his peers and went on for further specialized studies at a Rehabilitation School. He is an accomplished musician and works in the tourism industry. Early intervention and persistence is the key!!!!
I also think it's wonderful... anything that can be done to find out as early as possible! My life was hell everyday out in the world... I was diagnosed 3 years ago when I finally "broke" from the anxiety. My son is Asperger and he wasn't diagnosed until he was in his 30's. He has 3 autistic sons who were diagnosed quite young. The autistic child needs to somehow be made aware that they are not bad, dumb or unacceptable just because their brain is wired a little differently. They need to be taught to ACCEPT THEMSELVES. My slogan has become "I NEVER felt normal until I found out I'm not!" Now, I'm at peace with myself... I don't HAVE to try to be like others, because I'm NOT! I can just be ME and I'm fine with that. :)
I also tried tellin my sons ped. that something wasnt quiet right that he was way behind other kids his age...talked with another ped. who was also a friend of mine about my concerns,we scheduled an apt with her and after about 5 min with him she refered him 4 further evals. He is now getting therapies he needs and showing improvements...follow ur gut moms, no one knows ur child better than u...if ur dr doesnt listen, take them 2 some1 that will listen 2u. 2nd opions cant hurt any1
My kids didnt show any of these signs AT ALL.
I feel guilty that I let that doctor dismiss me so easily. I should have taken my son to see someone else. If you feel your child is different, DON'T let anyone tell you other wise!
My comment is the same as Zohmom's, except my Aspy was not diagnosed until 6th grade. My pediatrician had never even heard of sensory integration dysfunction when my son was diagnosed with it in the 4th grade.
What a great idea...anything that can help detect the possibility of Autism or any delay can result in a child getting the help they need so that there is a greater chance to get them help early so they can function with a more normal life.
I tried to tell my pediatrician there was something not right with my son early on. They said he was fine and I was worrying for nothing. He was diagnosed with Aspergers in the forth grade. Long after he had been continuously disciplined and disliked in school for behavior he couldn't control. I KNOW he would be a different person today if people had listened to me then.