by Katrina Hapner, contributing writer for Telegraph Local
For the first time in 12 years, the American Academy of Pediatrics have updated guidelines for the diagnosis and treatment of autism. Autism is a developmental disorder characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. In a report labeled, Identification, Evaluation, and Management of Children With Autism Spectrum Disorder, authored by Susan L. Hyman, MD, FAAP, Susan E. Levy, MD, MPH, FAAP, and Scott M. Myers, MD, FAAP, these updates were explained and will be published in the January paper issue of Pediatrics. In the report it is noted that since the year 2007, the incidence of Autism Spectrum Disorders has increased from 1 in 155 to 1 in 59, with the majority of those afflicted being male. This increase may, in part, be due to an increased awareness of the symptoms of Autism Spectrum Disorder and implemented screening in primary care practices.
With this report, the American Academy of Pediatrics advocates for routine screening for ASD in toddlers. The average age of diagnosis is 3 years of age, but it is possible to diagnosis children as young as 2 years of age. However, the AAP does not endorse any one tool for the screening of ASD, though different ones are currently being studied for their efficacy. The AAP recommends tracking of children who are at risk as they proceed through childhood and when developmental issues are identified, these children should be for early intervention and school services. Improved outcomes are achieved with early diagnosis and referral.
The AAP report supports a combination of behavioral and developmental approaches to help children with skill building. For many children with ASD, school can be challenging due to added issues with ADHD, anxiety and other secondary diagnoses that impact academic performance. The report recognizes that making the sensory symptoms of ASD a priority is important, as well as trying behavioral approaches before going to medication interventions.
With regard to genetics and neurobiology of this disease, research has progressed to where numerous genes associated with development of the brain have been identified. It is suggested that families should be offered genetic testing and as many as 30-40% of patients do show data on chromosomal microarray testing.
It is interesting to note, that many ASD children first presented to their doctors with sleep problems and/or food selectivity issues related to sensory problems with the color or texture of certain foods. Often obesity is an issue, as well as constipation, along with sleep disorders including wandering being very common with Autism Spectrum Disorder. They also note that children with ASD have increased risk of seizures.
One of the authors of the report, Susan E. Levy, M.D., FAAP, stated that it was discovered that with all the focus generally targeted on the causes of autism, research had not focused on the fact that “children with autism grow up to be adults with autism and we need to better help plan out with families the various transitions in their lives.”