Autism Detection Neglected

Here's what you need to know about the first signs of autism.


Pediatricians and parents need to be more aware of the first signs of autism, two new studies suggest. That's because early intervention can improve a child's development and in some cases even reverse the disorder. In a study of Atlanta children with autism spectrum disorders (ASD)--which include classic autism as well as its milder forms, such as Asperger syndrome--researchers found an average 13-month delay between first evaluation and diagnosis.

While the researchers didn't suggest reasons for the time lag, a separate study offers some clues. Pediatricians surveyed by Johns Hopkins said they weren't familiar with existing evaluation tools, referred suspected cases to a specialist or simply didn't have the time to screen. Among the 255 doctors polled, only 8 percent tested for ASD.

The studies' findings don't surprise Chris Johnson, M.D., chairwoman of the autism expert panel of the American Academy of Pediatrics (AAP) and professor of pediatrics at The University of Texas Health Science Center in San Antonio. "We didn't get an autism screening tool in the United States until the late '90s," she says. "And with a typical well-child checkup lasting 15 minutes, the screening, scoring and interpretation took nearly the whole appointment." Later the tool was modified to become a parent survey that asks 23 yes-no questions. But because the survey is just a few years old, many pediatricians aren't yet familiar with it.

Fortunately, that situation is beginning to change, thanks to increasing concern about growing autism rates and proof that early intervention helps, Johnson says. Last summer the AAP emphasized the importance of early detection by recommending that all children be screened for autism at their 18-month checkup. Parents also can download the survey at (look under "Screening"), complete it and take it to their pediatrician's office. If the staff doesn't know how to score it, the key is available on the website.

Meanwhile, share with your pediatrician any worries you may have about your child's development. "When parents have a concern, there's usually some sort of problem," Johnson observes. If there isn't time to address all your concerns, make a separate appointment to discuss them further. If the pediatrician can't or won't help, ask for a referral to another doctor or search online for a developmental pediatrician, whose appointment times often run one to two hours. "It's not that general pediatricians don't want to help spot autism," says Johnson. "But they don't always know how, and they definitely don't have the time."

Editor's Note: For the latest information on autism research, as well as red flags to look for in infants, see "Decoding Autism".