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Routine autism screenings bad for kids: Study 

By Sheena Goodyear, QMI Agency – Tuesday, June 14, 2011

Routinely screening children for autism could do more harm than good, according to a new Canadian study that flies in the face of recommendations from south of the border.

Autism is a group of neurodevelopmental disorders that seriously impact communication skills, social interaction and cognitive abilities. The Autism Society of Canada estimates one in every 200 Canadian children has some form of autism, ranging from minor to severe. While kids start displaying symptoms of autism as young as three, most aren’t diagnosed until they’re five, leading many researchers in recent years to push for earlier and more regular screenings.But the latest research from McMaster University in Hamilton, Ont., rejects this idea.

In a study published in the journal Pediatrics, researchers who reviewed current literature on autism screenings said there is “not enough sound evidence to support the implementation of a routine population-based screening program for autism.” They make this claim despite a 2007 recommendation from the American Academy of Pediatrics that all children be screened for autism at 18 and 24 months, and growing support for routine screenings from experts in the field.

But that kind of mass screening could easily lead to kids getting misdiagnosed, Dr. Jan Willem Gorter, the McMaster study’s lead author, told QMI Agency. That’s because the symptoms associated with autism can often turn out to be caused by something entirely different, he said. A child who doesn’t respond to his or her name could have hearing problems, for example. A child who has trouble socializing at age three might be the most popular kid on the block by the time they turn four.

Misdiagnosing autism would not only force kids to carry around the stigma of a disorder they don’t have but would also put an unnecessary burden on the health-care system, Gorter said. “There are limited resources for children to get the help they need. There are wait lists of one year or longer,” he said.

Other studies, however, have touted the benefits of early, wide-spread screening. A study earlier this month from the Children’s Hospital of Philadelphia, also published in Pediatrics, said systematic screening of kids between 14 and 24 months leads to early diagnoses and better care. The study used a simple questionnaire to spot early signs of autism, such as problems with communication and social interaction, to identify those most at risk.

A similar study in April from the National Institute of Mental Health in the U.S. showed that by administering questionnaires to toddlers’ parents and doctors, researchers could to accurately predict autism 75% of the time.

“This program is one that could be adopted by any pediatric office, at virtually no cost, and can aid in the identification of children with true developmental delays,” said that study’s lead author, Dr. Karen Pierce.

But the McMaster study warned this type of research is in the very early stages, and implementing routine screenings for autism turns kids into guinea pigs. “None of the autism screening tests currently available has been shown to be able to fulfill the properties of accuracy — namely, high sensitivity, high specificity and high predictive value (proportion of patients with positive test results who are diagnosed correctly) in a population-wide screening program,” the study said.

Nevertheless, Gorter said any child whose parents, teachers or doctors express concern should be screened.

“But that’s very different than going to the public and testing young children, all children, regardless if the parents have concerns,” he said. “Of course, parents’ concerns should always be taken seriously.”

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