Routine Autism Screening Recommended
Report Highlights Subtle Autism Signs to Look for During Wellness Visits With Doctor
Oct. 29, 2007 -- All children should be screened for autism at age 18 months and
again at age 2 even if they show no signs of developmental delay, according to
new guidelines from the American Academy of Pediatrics (AAP).
The hope is that universal screening during well-child pediatric checkups
will lead to earlier diagnosis of the disorder. There is growing recognition
that early diagnosis and intervention can result in better outcomes for
children with autism and related disorders.
The guidelines were released Monday at the AAP annual meeting in San
Francisco, along with reports highlighting developments in the identification
and management of autism.
The reports are published in the November issue of the AAP journal
Possible Signs of Autism
While language delays are the most common reason for evaluating children for
autism, more subtle warning signs have been identified for babies who are not
yet at the talking stage.
Some of these signs can be recognized before a child's first birthday,
including a delay in smiling, failure to follow a parent's gaze, and failure to
respond to his or her name or a parent's pointing gesture by age 10 to 12
Other early warning signs include:
- Failure to point as a means of directing a parent or caregiver's attention
by age 12 to 14 months
- Lack of "back and forth" babble with a parent or caregiver as a
means of communication by around the age of 6 months
- Failure to make eye contact
Forming an attachment with an uncommon object, such as a flashlight, keys,
or a ballpoint pin instead of a stuffed animal, blanket, or other soft item may
also indicate a problem.
But report co-author Chris Plauche Johnson, MD, is quick to point out that
many normally developing children form attachments to unusual objects, just as
many children with autism make eye contact.
"None of these subtle indicators should be taken in isolation as a
definite sign of autism," the University of Texas Health Science Center
pediatrics professor tells WebMD.
But they can alert parents and pediatricians to a potential problem before
less subtle indicators become obvious, she says.
Not-So-Subtle Autism Signs
The mostly verbal red flags that have previously been identified as absolute
indicators for evaluation are:
- No babbling, pointing, or other communication gestures by 12 months of
- No single words by age 16 months
- No two-word spontaneous phrases by 24 months
- Loss of language or social skills at any age
Neurodevelopmental pediatrician Scott Myers, MD, tells WebMD that roughly a
quarter of children with autism experience verbal regression. The average age
that this occurs is about 21 months, he says.
"There is certainly cause for concern if a child that was using 20 words
a few months ago suddenly doesn't have any language," he says.