Canadians resist call to screen all babies for autism

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Canadians resist call to screen all babies for autism


Another article on early diagnosis of autism focuses on how Canadian doctors approach this issue. The article can be found here: Canadians resist call to screen all babies for autism.

What does this mean? Sounds pretty horrible? If you read this in local papers this week you might be wondering what it means. Heres the story:

Canadian researchers are warning that not nearly enough evidence exists to support a move to screen every preschooler for autism, as U.S. doctors are urging.

In the U.S. paediatricians are being urged by their professional body (the American Academy of Pediatrics) to routinely check toddlers for signs of autism at 18 to 24 months of age during regular visits for checkups or vaccinations, regardless of whether the parents have any concerns about their babies. The are screening, and recently I addressed ways that this screening can take place, even at this age, through simple procedures and an interview.

But from McMaster University in Hamilton, Ont., we hear that current screening tools not good enough, “there is no evidence yet that such a program would do more good than harm.” It may be hard to understand, but sometimes when we do screening, based upon no reason at all, just screening everyone, we end up finding many false positives. Mass screenings for several adult disorders have come under fire recently just for this reason.

So while some feel that if autism screening were added to routine baby visits, virtually every child potentially could be reached, while others find that none of the screening techniques available today are sensitive enough to reliably detect — or rule out — autism. (Dr. Jan Willem Gorter, a researcher in McMaster’s CanChild Centre for Childhood Disability Research.) And there are many potentially negative impacts of a wrong diagnosis.

“These conclusions ( in Dr. Gorter's report) raise a fundamental question: what do we aim to achieve when we screen for a non-preventable condition for which there is currently no research evidence that intervention strategies improve the daily lives of all children with autism spectrum disorder and their families?” I know that may seem harsh, but realize they are saying that there is no evidence that early...ages 2,3,4 ....interventions will help, at all.

Others argue that early diagnosis and intervention are crucial. "Parents of children with autism have reported seeing signs of trouble before their baby’s first birthday but autism usually isn’t diagnosed until age three or four. Wait lists for diagnosis and treatment can stretch a year or more." So we have a situation where parents report they see early signs, however what we know about autism (right now, which isn't a lot) is that the physical changes that cause the symptoms we see in behavioural changes don;t occur till ages 3-4.  So, do we screen every child, and possibly make a good number of mistakes when diagnosing, or do we wait? Those who think the mistakes are worth it don't take into account the funding and limited resources, those who don't feel that there are no proven effective treatments for children of this age anyway. Both sides seem to have a point.

So, with the limited resources, do we diagnose? Or do we wait? And what difference will there really be? The truth is, sometimes screening can cause more harm than good. It's not an easy problem to solve, but we need to be sensitive to doctors and professionals on either side of the argument. Both sides have the best interests of the children in mind.



Read more: http://www.ottawacitizen.com/health/Canadians+resist+call+screen+babies+autism/4934804/story.html#ixzz1PCORkrOh