Updated Autism Guidelines Stress Earliest Screenings Possible

MONDAY, Dec. 16, 2019 (HealthDay News) -- For the first time in more than a decade, a leading pediatricians' group has issued new autism guidelines that emphasize early intervention.

Updated recommendations from the American Academy of Pediatrics (AAP) say screenings should be conducted at 9-, 18- and 30-month well-child visits and specific screening for autism should be done at 18 and 24 months.

"We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes," guidelines lead author Dr. Susan Hyman said in an AAP news release.

"There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies," said Hyman, a developmental and behavioral pediatrician at the University of Rochester and Golisano Children's Hospital, in Rochester, N.Y. "Interventions work best when they are early, when they are intense, and when they involve the family."

This is the first update of the AAP's clinical recommendations on autism in 12 years and reflects significant changes in understanding of the neurodevelopmental disorder.

The report was published online Dec. 16 in the journal Pediatrics.

More than 5 million Americans have autism and its prevalence has grown to 1 in 59 children from 1 in 155 in 2007.

Many people with autism have co-occurring conditions that should be treated, according to the AAP. They include intellectual disability, language disorders, attention deficit hyperactivity disorder (ADHD) and anxiety, sleep disorders, feeding problems, gastrointestinal symptoms and seizures.

About 40% of people with autism have an intellectual disability, and as many as 40%-60% of school-aged children and adults with autism have anxiety disorders, according to the AAP.

It supports the use of behavioral therapies for skill building and noted that combinations of therapies and approaches that include parents are becoming more common.

"Families play a key role in treatment and advocacy for a child with autism spectrum disorder," said report co-author Dr. Susan Levy. She is a developmental and behavioral pediatrician at Children's Hospital of Philadelphia and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

"They also need the support of the professional team, the clinicians, educators and therapists who are working alongside them," Levy said in the release.

Along with early screening, the AAP says pediatricians should ensure children with autism receive evidence-based services to help them with social, academic and behavioral needs at home and school, and to have access to appropriate pediatric and mental health care, respite services and recreation.

Pediatricians should also help youth with autism and their families plan a transition to adult medical and behavioral care, inform patients and families about the evidence for therapies, and refer families for possible participation in clinical research and to support groups.

While knowledge about autism has increased, much work remains to be done, according to the AAP.

"There need to be more equitable and affordable therapies for all families, from the time of diagnosis through employment and adult life," Hyman said. "All children deserve options and hope for productive, satisfying lives."

More information

The U.S. National Institute of Mental Health has more on autism.