The usual 10 to 20 minutes allotted to a well-child visit may not allow enough time to pick up atypical behaviors that point to autism risk.
The usual 10 to 20 minutes allotted to a well-child visit may not allow enough time to pick up atypical behaviors that point to autism risk, according to a new study.
To find out what is “optimally observable” in a 10-minute autism assessment, researchers videotaped 42 children aged between 15 and 33 months during 3 assessments, including the Autism Diagnostic Observation Schedule. Fourteen of the children had been diagnosed previously with early signs of autism; 14 had suspected language delays but not autism; and 14 were developing normally.
Two licensed psychologists with expertise in autism spectrum disorders analyzed 2 10-minute videos of each child’s autism assessment without knowing the child’s diagnostic status. They evaluated 5 behaviors-responding, initiating, vocalizing, play, and response to name-then decided whether they would refer the child for an autism evaluation.
Dermcase: Purple papules pop up after antibiotic course
Based on the video clips, the psychologists missed recommending referrals for 39% of the children with autism. Within the 10-minute time frame, the children with autism exhibited more typical behaviors (89% of the time) than atypical behaviors (11%) overall. During brief observations, the researchers note, typical behaviors may exceed atypical behaviors in some children with autism to such an extent that even experts have trouble discerning whether a referral for evaluation is warranted.
They conclude that “brief clinical observations may not provide enough information about atypical behaviors to reliably detect autism risk” and suggest that the decision-making process for referral should take into account all available data, including autism screening tools, parent observations, developmental testing, and a detailed history.
To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.
Cerliponase alfa FDA approved to slow loss of ambulation in children of all ages with CLN2 disease
July 25th 2024From baseline to final assessment, all 7 matched cerliponase alfa-treated children under 3 years of age maintained a motor score of 3, representing a "grossly normal gait, signifying a delay in disease onset," stated BioMarin.