Two new clinical reports from the American Academy of Pediatrics (AAP) will help pediatricians recognize autism spectrum disorders (ASDs) earlier and guide families to effective interventions, which will, ultimately, improve the lives of children with ASDs and their families.

The first clinical report, “Identification and Evaluation of Children with Autism Spectrum Disorders,” provides detailed information on signs and symptoms so pediatricians can recognize and assess ASDs in their patients. Language delays usually prompt parents to raise concerns to their child’s pediatrician - usually around 18 months of age. However, there are earlier subtle signs that if detected could lead to earlier diagnosis. These include:

• not turning when the parent says the baby’s name;
• not turning to look when the parent points says, “Look at…” and not pointing themselves to show parents an interesting object or event;
• lack of back and forth babbling;
• smiling late; and
• failure to make eye contact with people.

Most children, at some time during early development, form attachments with a stuffed animal, special pillow or blanket. Children with ASDs may prefer hard items (ballpoint pens, flashlight, keys, action figures, etc.). They may insist on holding the object at all times.

The report advises pediatricians to be cognizant of signs of ASD, as well as other developmental concerns, at every well-child visit by simply asking the parents if they or their child’s other caregivers have any concerns about their child’s development or behavior. If concerns are present that may relate to ASD, the clinician is advised to use a standardized screening tool. The report also introduces universal screening, which means pediatricians conduct formal ASD screening on all children at 18 and 24 months, regardless of whether there are any concerns.

“Red Flags” that are absolute indications for immediate evaluation include:

• no babbling or pointing or other gesture by 12 months;
• no single words by 16 months;
• no two-word spontaneous phrases by 24 months; and
• loss of language or social skills at any age.

Early intervention can make a huge difference in the child’s prognosis. “Autism doesn’t go away, but therapy can help the child cope in regular environments,” sayd Chris Plauche Johnson, MD, MEd, FAAP, and co-author of the reports. “It helps children want to learn and communicate.”

Source: American Academy of Pediatrics