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Tuesday, August 30, 2016

Early Autism Diagnosis Key To Effective Treatment, Study Finds

From The Oregonian
via DisabilityScoop

By Kale Williams
August 16, 2016

Children diagnosed with autism spectrum disorder before the age of 4 are more likely to get effective treatment than those who are determined to have the disorder after that threshold, researchers at Oregon Health and Science University found.

Additionally, researchers found that longer delays between when parents first discuss concerns about their children with their health provider and when a diagnosis is reached were linked with a higher use of alternative and complementary medicine, which have not been shown to be as effective as behavioral therapy.

The findings come in a study published online this month in Psychiatric Services, an academic journal, led by Katharine Zuckerman, a professor of pediatrics at Doernbecher Children’s Hospital at OHSU.

“The problem is, in the U.S., kids just aren’t getting screened,” Zuckerman told the Oregonian/OregonLive.

Past research has shown the most effective treatment for the disorder is behavioral intervention therapy aimed directly at core autism symptoms like impaired social skills and inflexible behaviors.

“The strongest treatment comes from a child working intensively with a therapist one-on-one specifically on their symptoms, which can be trouble with social interaction or repetitive actions that get in the way of normal behavior,” Zuckerman said.

Early treatment of these symptoms can pay long-term dividends for children’s functioning as they grow up, but there’s no way to know what type of treatment a child needs until they’ve been diagnosed.

Zuckerman and other researchers analyzed the experiences of more than 700 children between the ages of 6 and 11 with autism spectrum disorder. The team looked at the use of a wide variety of health services, including behavioral intervention therapy or school-based therapy — which can include social skills training, occupational therapy, physical therapy, or speech and language therapy.

They also evaluated the effectiveness of complementary and alternative medicine, such as nutritional supplements, and psychotropic medications, but those treatments don’t have the same level of evidence supporting their effectiveness.

Beyond that, researchers found that parents usually first brought up developmental concerns with their doctor when their child was just over 2 years old, but the average age for diagnosis was over the age of 4.

Use of complementary and alternative medicine was nearly twice as likely for children with delays of longer than 2 years, according to the study.

The American Academy of Pediatrics has recommended all children be screened for autism at both 18 and 24 months, but only about half of primary care practitioners screen for the disorder. Although the disorder can usually be detected by the age of 2, the average age for diagnosis is over 4, Zuckerman said.

“Most pediatricians still aren’t doing it,” she said of early screenings. “There is a problem of awareness and some doctors don’t know what to do if they get a positive test. Whether the parents are unaware or the doctors are uneducated, it’s a big problem for the health care system.”

Zuckerman recommended that parents who think their child might be showing symptoms of the disorder take an online screening, which can predict a positive diagnosis with about 50 percent accuracy.

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