Doctor Visits May not Provide Enough Information on a Child to Prompt a Needed Autism Referral

A new study by researchers at Brigham Young University finds that many pediatric checkups don’t provide enough information about the children being examined to determine that a child is autistic. According to the researchers, during such a short window many children show mostly typical behavior and so may not get a referral for additional testing for autism.

“One of the biggest problems with early identification of autism is that many children aren’t identified until they reach the school system,” said the study’s lead author and BYU assistant professor Terisa Gabrielsen. “This means that they have missed out on some prime years for intervention that can change a child’s outcome.”

According to the Centers for Disease Control and Prevention, 1 in 68 U.S. children has an autism spectrum disorder which is a thirty percent increase, from 1 in 88 from two years earlier.

For the study, autism experts evaluated ten minute videos of children 15 to 33 months old during a clinical checkup. Included in the children evaluated were children with autism and speech delays and children evaluated to have no delays. The researchers found that children with autism exhibited much more typical behavior than atypical behavior overall during the videos, making it easy for clinicians to miss detecting a risk for autism. In fact, the experts who reviewed the videos missed referrals for 39 percent of the children with autism, based on the videos.

“Decisions for referral need to be based on more information, including autism screening and information from parents,” says Gabrielsen. “We’re hoping that this information can really empower parents to talk with pediatric care providers about their concerns.”

The American Academy of Pediatrics recommends formal screening for autism at 18 and 24 months and screening tools are also available for parents including the Learn the Signs. Act Early website from the Centers for Disease Control and Prevention. Early diagnosis of autism is critical, say the researchers, so intervention can begin while the brain is still rapidly developing and outcomes can change.

The study was published in Pediatrics.

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