Optimal Outcome for Autism

1/30/17 Email to TheAutismDoctor.com 
Hello, 
I am a student doing a research paper on the over-diagnosis of autism. Do you think the over diagnosis of autism is rising? …Thank you and your response is greatly appreciated!

Dr. Udell
There is a controversy about whether or not autism is being ‘over diagnosed’, or it is simply being recognized more accurately. If earlier recognition of the problem results in fewer children with school problems, it might not matter what the condition is called.

With all of the confusion about autism diagnosis, it probably isn’t that surprising that a youngster in today’s world, writing a school report on autism, chose ‘over-diagnosis’ as her main focus.

Over-diagnosis?
Last year, a paper entitled, Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis was popularly presented as, Government Study Suggests Autism Overdiagnosed.

Research appearing more recently, Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses could have engendered a similar conclusion.

Changing the paradigm
Appearing in Policy Insights from the Behavioral and Brain Sciences was an important document that will further diagnosis and treatmentOptimizing Outcome in Autism Spectrum Disorders.
ASD can result in a wide range of outcomes,
from need for lifelong care to successful adult functioning.

Intensive behavioral intervention can change the course of development and outcome, especially if intervention begins in early childhood.

To receive effective early intervention, the individual
must be detected, and then diagnosed early.

Screeners for autism are effective; some concerned stakeholder organizations endorse universal autism screening at 18 to 24 months.

Children from economically disadvantaged or ethnic minority families are detected and diagnosed up to 2 years later, delaying their access to intervention and limiting their outcome.

To detect ASD in early childhood and reduce treatment disparities, physician surveillance and elicitation of parental concerns should be augmented by universal screening.

The author concluded:

“The cost of effective early intervention is significant; however, the impact of failing to provide this intervention in long-term costs and unrealized human potential is much greater.”

This week, ScienceDaily reportedResearchers outline new policies for earlier detection of autism in children. ABC News reported, “Autism diagnosis spike linked to change in understanding of spectrum, study finds.”

Much better!

Discussion
This information should improve our understanding of the true spectrum of signs and symptoms that are characterized as ASD, and provide methods to address the situation.

It outlines clinicians’ early responsibility to assist the family in checking for red flags; over-diagnosing, God forbid, a newly perceived developmental anomaly. Nomenclature notwithstanding, there are delays that can be ameliorated, especially with earlier recognition.

Conclusion
Importantly, these guidelines expose what children need, if not precisely how they arrived with the developmental challenges. From a biomedical standpoint, it highlights a pediatric specialists’ need to understand an appropriate workup, rather than an old-fashioned hand-off to another specialist.

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Brian D. Udell MD
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