Autism: The Critical Importance of Early, Individualized Diagnosis

Mr. Rokuskie:
As diagnostic information becomes more readily available and prevalence rates for autism spectrum disorder keep increasing, it is becoming ever more evident that it is important to get early diagnosis for individuals to help for their families and those being diagnosed with autism spectrum disorder.

You’re listening to ReachMD. I am your host, Paul Rokuskie, and with me today is Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities. Welcome, Dr. Shapira.

Mr. Rokuskie:
Dr. Shapira, can you talk about the diagnosis criteria?

Dr. Shapira:
The recent ADDM Network report looked at the age of developmental concerns for children, the age where children received evaluations for the concerns, and the diagnosis of children with ASD, and found that a lot more work needs to be done to get children into the services they need as early as possible. For example, 17 out of 20 children identified with ASD had concerns about their development documented in their records before the age of 3 years. However, less than 1/2, or only 8 in 20, had a comprehensive developmental evaluation by age 3 years. Therefore, frequently, there’s a lag between the first concern about development and the first developmental evaluation. This lag may affect when children with ASD can begin to get the services they need, and getting services as early as possible can make a difference in the development of the child with ASD. Now, a child does not have to have a diagnosis of ASD to receive services, but a diagnosis can help frame services, so an early diagnosis can be beneficial.

Diagnosis of ASD can often be made by an experienced professional by age 2. However, in the ADDM Network report, the average age of diagnosis for those who received an ASD diagnosis by a professional was a little under 4 ½ years, so obviously, we have a ways to go to assure that children with early developmental concerns are receiving comprehensive developmental evaluations, and children with a suspicion for having autism are being diagnosed early by an experienced professional. The American Academy of Pediatrics recommends screening children for ASD at 18 and 24 months of age. It is important that all children get screened and referred for further evaluation if there are any concerns. A “wait and see” approach is almost never warranted.

Mr. Rokuskie:
Definitely having a diagnosis of autism is an important factor. My oldest son was a premature baby, and we were anticipating developmental delays and was getting services for that, but he didn’t actually get a diagnosis of autism until age 4. And once we got that diagnosis, the services that he was receiving, they honed them in more with an autism eye to what they were doing, and we saw dramatic increases in his progress versus what we had seen prior to that when he didn’t have the diagnosis of autism. So it’s important to get those services right away, but I agree completely that it’s important that autism or intellectual disability or whatever diagnosis is there as definitely see increasing in the potential for that individual.

Dr. Shapira:
Absolutely. A child with developmental concerns can start receiving developmental services as early as a concern is recognized, so before the age of 3 children can receive services through the early intervention program and after the age of 3 through the local public school system. There doesn’t have to be a diagnosis, just a concern about development; but as I mentioned, a diagnosis of ASD can help frame services more appropriately for the child, so an early diagnosis of ASD can also be very beneficial.

My thanks again to my guest, Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities.

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I’ve been your host, Paul Rokuskie. Thank you for listening.