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Positive Screen for Autism Often Does Not Spur Further Evaluation

More than two-thirds of toddlers flagged for autism at doctor visits do not get assessed for the condition by specialists, according to a study of more than 13,000 children1.

Most children are screened for autism at 18 and 24 months, as the American Academy of Pediatrics recommends. It’s after this step that the system fails autistic children, the study suggests.

“Pediatricians are doing a great job screening kids,” says study investigator Sonia Monteiro, assistant professor of pediatrics at Baylor College of Medicine in Houston, Texas. But “what happens after screening matters.”

Nearly 60 percent of the children flagged by screening were diagnosed with developmental delays or language disorders. Many were offered treatment for those conditions.

The researchers reviewed electronic medical records for well visits in the Texas Children’s Hospital network from 2014 to 2016. The network includes 290 pediatricians at 54 pediatric primary care practices.

Of 13,417 toddlers, 93 percent were screened at 18 months using the Modified Checklist for Autism in Toddlers (M-CHAT). At 24 months, 82 percent of 13,328 toddlers were screened. The checklist is a widely used screen that comprises 23 yes-or-no questions that probe social, motor and language skills. The findings were published 12 September in Pediatrics.

Many children the M-CHAT flags do not have autism. A study published last week showed that 85 percent of the children the screen flags for autism do not have the condition2. But the earlier those who do have it are diagnosed and receive treatment, the better their outcomes.

Analyzing what happens in clinics, as the new study did, is critical to understanding the diagnostic process, says Judith Miller, senior scientist at the Center for Autism Research at the Children’s Hospital of Philadelphia, who was not involved in the study. “Only by studying real-world practice can we improve real-world care.”

Excerpted from “Positive Screen for Autism Often Does Not Spur Further Evaluation” in Spectrum News. Read the full article. The study abstract is available on PubMed.

References:
  1. Monteiro S.A. et al. Pediatrics 144, e20183326 (2019) PubMed
  2. Guthrie W. et al. Pediatrics Epub ahead of print (2019) PubMed
Source: Spectrum News | Positive Screen for Autism Often Does Not Spur Further Evaluation, https://www.spectrumnews.org/news/positive-screen-for-autism-often-does-not-spur-further-evaluation | © 2019 Simons Foundation

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