June 13, 2011
By Jeff Green
An autistic diagnosis changes the course of child's life, and their parents' lives.
What if it isn't true?
That is something McMaster researchers are trying to avoid, asking for a call to action from the research community against a recent proposal recommending routine autism screening for all children.
"You could miss-label a child," said McMaster researcher Dr. Jan Willem Gorter. "We know that a child can be over diagnosed based on symptoms. For example, if a young child doesn't respond to its name it could well be an early sign of autism.
"But it could also be something as simple as a hearing difficulty."
Gorter is a researcher for McMaster's CanChild Centre for Childhood Disability Research and associate professor of pediatrics. His findings in a literary review suggest that there are no good screening tools and no evidence that routine screening will do more good than harm, contrary to a recent recommendation by the American Academy of Pediatrics (AAP) incorporate autism screening into routine practice.
"These tests are not developed primarily for screening. If you apply them in a screening situation, we don't know how they would function," said Gorter, commenting on his study published in the journal, Pediatrics.
"(The AAP) makes an argument that we have to look for symptoms."
The AAP asks for screening to be incorporated to regular practice at age 2, regardless of concerns from parents, and suggest it could be incorporated into a child's physical check-up.
Gorter says the test is harmless, but the test's accuracy as a screen against all children has yet to be proven.
"Some might have the label of autism that don't have the diagnosis," added Gorter.
Margaret Spoelstra, executive director of Autism Ontario, was encouraged by news of a potential early screening method for children, and the potential to diagnose autism at its first symptoms.
"That gives families choices and we can provide early intervention. Those two things matter tremendously to families. Better choices because they're knowledgeable about their child's diagnosis, and that early intervention can occur for long term positive impact," said Spoelstra.
Formally known as the autism spectrum disorders (ASDs), autism is a neurological disorder causing developmental disability, according to the Autism Society of Canada. People with autism social and communicative difficulties, and have abnormal patterns of interests and behaviors.
McMaster stated that autism is more common in males at a 4:1 ratio, and affects 11 in 1000 children. 30 years ago, it only affected 0.8 in 1000 children, an increase that could be from improved detection or an actual increase in the disorder.
Gorter recommended that preschoolers showing signs of language, social or cognitive problems should be watched carefully and avoid screen children with a test that has yet to proven accurate.