Autism - The Importance of Early Detection
April 27, 2012
The American Academy of Pediatrics recommends toddlers be screened for autism starting at 18 months of age. However, autism can be detected as early as 14 months of age. Early diagnosis is crucial. Although there is still no cure for autism, experts believe that therapy works best the younger the patient is when therapy begins.
On average, children in the U.S. are not diagnosed until they reach four and a half years old, according to government statistics.
Dr. Rebecca Landa, the autism director at the Kennedy Krieger Institute in Baltimore, states that cultural differences in how parents view developmental milestones and how they interact with doctors may provide some rationale for the discrepancy. For example, babies tend to point before they talk, but in some cultures pointing is considered rude, and a new parent may not miss the behavior. In other cases, the fact a child is not talking yet may be explained away by family history such as "don't worry — Cousin Harry spoke late, too, and he's fine."
Another autism expert, Dr. David Mendel of the University of Pennsylvania, has led studies that show white children are diagnosed with autism as much as a year and a half earlier than minority race children. He adds that socioeconomic factors play a role in minority race families who may have less access to education and health care.
Meanwhile, Dr. Landa's preliminary research shows that even when minority race children are diagnosed in toddlerhood, they have more severe developmental delays than white children. She leads a toddler treatment program at Kennedy Krieger where she has found that minority race children with autism lag approximately four months behind white children with autism in language development. "Autism Not Diagnosed As Early In Minority Children: Study," www.huffingtonpost.com (Feb. 28, 2012).
Commentary and Checklist
According to the Centers for Disease Control and Prevention (CDC), one child in 88 has an autism spectrum disorder (ASD). According to estimates from the CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network, ASDs are almost five times more common in boys (1 in 54) than in girls (1 in 252).
In addition, the CDC reports certain risk factors associated with autism. For one, parents who have a child with an ASD have a 2–18 percent chance of having a second child who is also affected. About 10 percent of children with autism are also identified as having genetic or chromosomal disorders such as Down syndrome, fragile X syndrome and tuberous sclerosis. Finally, children born to older parents are at a higher risk for ASDs.
So, what are the signs of autism? According to the Mayo Clinic, children with autism suffer in three crucial areas of development — social interaction, language and behavior. Some show signs in early infancy. Others develop normally for the first few months or years and then show signs of autism. Symptoms vary greatly, but the Mayo Clinic suggests the following signs to watch for:
- A child who barely makes eye contact;
- A child who does not respond to his or her name;
- A child who appears not to hear you at times;
- A child who resists when you cuddle or hold him;
- A child who seems unaware of people's feelings;
- A child who retreats into his or her "own world";
- A child who starts to talk later than age 2 and who is developmentally delayed by 30 months in other areas;
- A child who loses the previously-acquired ability to say words or sentences;
- A child who speaks with an abnormal tone or rhythm and may use robot-like speech or a singsong voice;
- A child who cannot start a conversation or keep one going;
- A child who may be able to repeat words or phrases verbatim, but does not understand how to use them;
- A child who performs repetitive movements, such as rocking, spinning or hand-flapping and is constantly moving;
- A child who becomes upset at the slightest change in routines or rituals;
- A child who is unusually sensitive to light, sound and touch and yet seems oblivious to pain; and/or,
- A child who is fascinated by certain objects or parts of an object.