Doctors Often Miss Signs of Autism

Eileen Bailey Health Guide
  • We know that early identification of autism spectrum disorder (ASD) is important. When it is identified and interventions are put into place early in a child’s life, the outcome is more positive than if it is diagnosed later in life. We also know that children as young as two years old can be accurately diagnosed with autism, even though most children don’t get diagnosed until after the age of four years old, according to the U.S. Centers for Disease Control and Prevention.

    A study, completed at the University of Utah by Terisa Gabrielsen (now an assistant professor in the department of counseling, psychology and special education at Brigham Young University in Provo, Utah), showed that doctors, including those that specialize in ASD, missed early signs of autism in almost 40 percent of the children in the study.

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    The American Academy of Pediatrics (AAP) recommends that doctors routinely pay attention for signs of ASD at every well child preventive visit and complete screenings at 18 and 24 months old. Anytime concerns are noted, the child should be referred for a complete screening.

    During the study, two psychologists who specialize in treating ASD, were shown videos of 42 children going through three screenings for autism, including the Autism Diagnostic Observation Schedule. Of the participants, 14 had previously been diagnosed with ASD, 14 did not have autism but had suspected language delays and 14 were typically developing. After watching the videos, the psychologists decided whether they would refer the child for an autism assessment. Surprisingly, the psychologists missed 39 percent of the children with autism.

    In the videos, which lasted only 10 minutes, only 11 percent of the children with autism showed atypical behaviors. According to the researchers, “We were surprised to find that even children with autism were showing predominantly typical behavior during brief observations. A brief observation doesn’t allow for multiple occurrences of infrequent atypical behavior to become evident amidst all the ypical behavior.” Complete assessments for ASD can last anywhere from several hours to several days.

    While the AAP encourages doctors to screen for autism during routine check-ups, the time usually given for these exams doesn’t give doctors enough time to fully observe behaviors to determine if the child should have further screening. Communication between parents and pediatricians is important. If parents notice any atypical behaviors or red flags for autism, they should discuss these with the doctor. Some of the early red flags include:

    • No big smiles by six months
    • No back-and-forth communication by language or gestures by 12 months
    • No words by 16 months
    • No two-word phrases by 24 months
    • Loss of language or social skills at any age

    Parents cab also use the Modified Checklist for Autism in Toddlers, available online and share the results with their pediatrician.

Published On: January 13, 2015