Friday, February 23, 2018
Dr. Chelsea Bodnar, a board certified pediatrician, member of the American Academy of Pediatrics Council and a mother of three discusses what you should expect from your pediatrician or health care provider when it comes to screening for autism. The guidelines are unambiguous. Despite what some people may tell you, even including some health care providers and pediatricians, the American Academy of Pediatrics recommendations are crystal clear. All children should receive screening. No exceptions. The American Academy of Pediatrics recommends that all children receive screening for autism at their 18 and 24-month well-child visits. Thanks to these recommendations, these screening services are deemed a preventive health service are covered my most insurance plans.
The importance of developmental screening for ALL children can not be over emphasized.. Studies show screenings are accurate. And research shows treating children earlier for autism can help mitigate its effects. Screening can identify at risk children early, when they may benefit most from intervention. For screening to be effective however, it must be applied to all children – not just those with symptoms. Screening occurs prior to diagnosis. And just because your child has a positive screen for ASD, it doesn’t mean he or she will actually be diagnosed with autism.
For screening, most pediatricians use the M-CHAT, a short questionnaire filled out by parents that most families find easy to complete. Using this standardized screening tool, pediatricians can identify children at risk for autism, which will prompt follow-up conversations about monitoring language and behavioral development, as well as possible next steps – which may include a formal diagnostic test. Any child who fails the MCHAT should be re-screened approximately one month later. As with any screening instrument, a second M-CHAT is advisable so that those children who are just slightly delayed are given time to catch up and also to focus efforts on children who are failing consistently.
Unfortunately, the Center for Disease Control found that only about 20% of children between the ages 10 months and 5 years received a standardized developmental screener, such as the M-CHAT, in their previous year. As a parent, you should politely insist that your child receive M-CHAT screening for autism at the benchmark ages of 18 and 24 months. And remember, screening tests don’t always identify all children with ASD. The rate of success for the M-CHAT isn’t 100%, so it should be used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the utmost importance. If your child screens normally but you continue to worry about autism, don’t be shy in following up with your pediatrician to re-screen.
Remember, there is no “judgment call” to be made about whether or not to screen for autism. The American Academy of Pediatrics guidelines are explicitly clear that ALL children should receive screening for autism and related development disorders.