The prevalence of autism in the U.S. has soared in recent decades. There is no single verifiable cause and no magic pill for treatment. But new research suggests earlier diagnosis is possible and, with that, hope for a better outcome.
The earlier we start good targeted intervention, the better chance we have at molding some of the brain circuits that we know are important for language and social interaction and the things that are impaired in autism, said Dr. Shafali Jeste, an autism expert at the University of California, Los Angeles.
There is no blood test to quickly alert parents that their young children need help. Instead, diagnoses often dont come before age 4 or 5 and are made when behaviors seem atypical or when childhood milestones are missed.
Beyond regular developmental screenings by doctors, the U.S. Centers for Disease Control and Prevention encourages parents to contact their doctors if they suspect a problem with the way their child plays, learns, speaks, acts or moves.
Last year the CDC raised its autism prevalence estimate to 1 in 68 American children from 1 in 150 in 2000. The advocacy group Autism Speaks says that the number of children in the U.S. with autism has increased tenfold in 40 years.
As with many things in the world of autism, there is controversy about the reasons for the increase. Some of the increase likely can be attributed to changes in the way the disease is diagnosed. In 2013, the American Psychiatric Association changed the guidelines for diagnosing autism, putting Asperger syndrome and childhood disintegrative disorder, among others, under one category now known collectively as autism spectrum disorder, or ASD. A Danish study published in JAMA Pediatrics suggests that much of the increase is due to such a broadening of the criteria for diagnosis. But the authors also noted that the changes dont account for all of the increase.
Figures aside, the ability to make an early diagnosis is improving. While the CDC reports that the median age for autism diagnosis is after a childs 4th birthday, there is evidence that use of a simple questionnaire for parents and pediatricians can reduce that age by about two years.
Diana Robins, who heads a research program at the A.J. Drexel Autism Institute, has developed, with others, the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised). Robins reports in a recent study in the journal Pediatrics that use of the tool can reduce the diagnosis age to about 25 months. An earlier diagnosis means intervention can begin earlier, and thats the good news.
Kids who start treatment earlier have a better chance of developing fluent language, Robins said. They have a better chance of being integrated into a typical classroom in elementary school, and they have a better chance of long-term success in terms of independence, the ability to go into higher education or be part of the work force.
But early intervention is no panacea, Robins added.
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Early diagnosis and intervention key with autism improvement