Should You Screen for Autism?

Article first published as Should You Screen for Autism? on Technorati.

Reports are coming in about an article published in the journal Pediatrics about Canadian researchers who, through a review, have pointed out the inconsistencies in Autism diagnosis, and therefore find no benefit for screening for Autism. To date I have been unable to locate this article, so I can't comment on the science behind it. From what I understand based on media reports, the researchers did a review of Autism literature regarding screening success, margins for error, and made their conclusions based on this review.

Without reading the article, I thought I would throw my own two cents in regarding this basic concept. Should screening be a priority for your child? The question is very much a "it depends" answer. You know your child best, and you know his behaviors. What's more, your pediatrician knows what behaviors are typical "Autistic" behaviors, and can be an excellent resource. But is screening really necessary?

Yes, in that many states with Autism resources (special schools, funding, etc.) require a diagnosis in order for families to have access. Without a screening by a licensed professional, you can't get access to those services. But if your health insurance policy doesn't cover Autism, then you are looking at one hefty bill, though many states with Autism services have a free screening as part of the services provided.

But, there are some stigmas that can be associated with an Autism diagnosis, I suppose. Your child will be "labeled", and become a subject of curiosity and conversation with family members to complete strangers. Though, honestly, not anything more than normal with melt-downs in public places, anti-social behavior, etc. that is typical of a child with Autism.

And is it necessary to have an exact diagnosis of where on the Spectrum the child is? I contend that it is not important. As every person with Autism is unique, knowing where on the spectrum a child is becomes more a need for labeling, rather than benefiting the child's development. Schools will work out an Individual Education Plan (IEP) for your child based on continuous observation of the child. This continuous observation is far more useful to you as a parent than a "snapshot" diagnosis taken after only an hour or two of observation. Just having the diagnosis is enough, getting the precise label is not as important.

So when wouldn't you want to get a screening for Autism? When your child has no behavior that fits in the Autism spectrum. If your child is not compulsively stacking items or lining them up, doesn't walk really close to the wall, has no fear of strangers, doesn't give eye contact, doesn't yawn with others (did you know it was a social thing?), and doesn't speak or has speech delays. There are other signs of Autism, but these are pretty common and easy to spot.

But what about misdiagnosis, you may ask? Because Autism is currently defined by behavior instead of genetics, and as many different conditions out there can mimic autistic behavior, it's possible to misdiagnose a child on the Spectrum when they instead have something like Fragile-X, celiac disease, or a number of other genetic diagnoses that can cause acute behavior changes. The only way to be sure of an Autism diagnosis is to have a genetic test, which is currently in trial with a high accuracy rate.

So, back to the original question: should you get your child screened for Autism? If you want access to those services, then you had better get your child screened. If you don't think it's necessary, and your pediatrician agrees, it's not as important. Though there was one thing reported about that article with which I completely agree, and that is to learn how your child learns, and cater to it. Nothing can change your child's life more than to help them learn.