Strongest push yet to have all children screened for autism

From Volume 4 Number 10

SAN FRANCISCO, USA: America's leading group of paediatricians is making its strongest push yet to have all children screened for autism twice by the age of two, warning of symptoms such as babies who do not babble at nine months and one-year-olds who do not point to toys.
    The advice is meant to help both parents and doctors spot autism sooner. There is no cure for the disorder, but experts say that early therapy can lessen its severity.
    Symptoms to watch for and the call for early screening come in two new reports. They were  released by the American Academy of Pediatrics at its annual meeting in San Francisco and appeared in the journal, Pediatrics, and on the group’s website -
    The reports list numerous warning signs, such as a four-month-old not smiling at the sound of Mom or Dad’s voice, or the loss of language or social skills at any age.
    Experts say that one in 150 children has the developmental disorder in the United States.
    “Parents come into your office now saying: ‘I’m worried about autism’' Ten years ago, they didn’t know what it was,” said Dr Chris Johnson of the University of Texas Health Science Center in San Antonio. She co-authored the reports.
    The academy’s renewed effort reflects growing awareness since its first autism guidelines in 2001. A 2006 policy statement urged autism screening for all children at their regular doctor visits at age 18 months and 24 months.
    The authors caution that not all children who display a few of these symptoms are autistic and they said parents should not overreact to quirky behaviour.
    Just because a child likes to line up toy cars or has temper tantrums “doesn’t mean you need to have concern, if they’re also interacting socially and also pretending with toys and communicating well,” said co-author Dr Scott Myers, a neurodevelopmental paediatrician in Danville, Pennsylvania.
    “With awareness comes concern when there doesn’t always need to be,” he said. “These resources will help educate the reader as to which things you really need to be concerned about.”
    Another educational tool, a website that opened in mid-October 2007, offers dozens of videoclips of autistic kids contrasted with unaffected children’s behaviour. That website - - is sponsored by two non-profit advocacy groups: Autism Speaks and First Signs. They hope the site will promote early diagnosis and treatment to help children with autism lead more normal lives.
    The two new reports say children with suspected autism should start treatment even before a formal diagnosis. They also warn parents about the special diets and alternative treatments endorsed by celebrities, saying there is no proof those work.
    Recommended treatment should include at least 25 hours a week of intensive behaviour-based therapy, including educational activities and speech therapy, according to the reports. They list several specific approaches that have been shown to help.
    For very young children, therapy typically involves fun activities, such as bouncing balls back
and forth or sharing toys to develop social skills. there is repeated praise for eye contact and other behaviour autistic children often avoid.
    Mary Grace Mauney, an 18-year-old high school senior from Lilburn, Georgia, has a mild form of autism that was not diagnosed until she was nine. As a young girl, she did not smile, spoke in a very formal manner and began to repeat the last word or syllable of her sentences. She was prone to intense tantrums, but only outside school. There, she excelled and was in gifted classes.
    “I took her to a therapist and they said she was just very sensitive and very intense and very creative,” said her mother, Maureen, 54.
    Paediatricians should send such children for “early intervention as soon as you even think there's a problem,” Johnson said.
    Dr Ruby Roy, a paediatrician with Loyola University Medical Center, who treats at least 20 autistic children, applauded the reports.
    “This is a disorder that is often missed, especially when it’s mild, and the mild kids are the ones ... who can be helped the most,” Dr Roy said.
    Dr Dirk Steinert, who treats children and adults at Columbia St Mary’s clinic in suburban Milwaukee, said the push for early autism screening was important - but added that it was tough to squeeze it into a child's regular wellness check-up.
    Some paediatricians have tried scheduling a visit just to check for developmental problems, when children are two-and-a-half. The problem was that insurance did not always cover these extra visits, Dr Steinert said.

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