In the Journals

New autism recommendations emphasize importance of early intervention

The AAP updated its clinical recommendations for autism spectrum disorder, or ASD, for the first time in 12 years, emphasizing the importance of early detection and intervention strategies and describing concomitant conditions like anxiety and ADHD.

ASD affects one in 59 children in the United States. Since the previous ASD recommendations were published in 2007, “the body of research supporting evidence-based interventions has grown substantially,” the AAP said. The updated guidance “reflects this new evidence and offers recommendations to physicians in identifying and managing the disorder, and in treating common co-occurring conditions.”

“We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes,” Susan L. Hyman, MD, FAAP, developmental and behavioral pediatrician at the University of Rochester and Golisano Children’s Hospital, said in a news release. “There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies. Interventions work best when they are early, when they are intense and when they involve the family.”

Direct and indirect costs of caring for children and adults with ASD in the U.S. were estimated to be $268 billion in 2015, Hyman and colleagues noted in the new clinical report, which was published in Pediatrics. They said lifetime costs for education, health and other necessary services can range from $1.4 to $2.4 million.

Increasing rates of ASD diagnoses can likely be attributed to broader diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, increased public awareness of ASD and its symptoms, recommendations for universal screening and increased availability for early intervention and school-based services for children with ASD, Hyman and colleagues said.

The report includes the following updated recommendations for pediatricians, as summarized by the AAP:

  • Conduct developmental and behavioral surveillance during all well visits with children, including developmental screening at 9, 18 and 30 months, and standardized screening for ASD at 18 and 24 months;
  • Help ensure children with ASD are provided with evidence-based services to address behavioral, social and academic needs at home and school, with access to appropriate pediatric and mental health care, leisure activities and respite services;
  • Engage with families and youth to plan the transition into the adult medical and behavioral care system; and
  • Inform families and patients about the evidence for interventions, and refer families for possible participation in clinical research and support organizations.

“There needs to be more equitable and affordable therapies for all families, from the time of diagnosis through employment and adult life,” Hyman said. “All children deserve options and hope for productive, satisfying lives.”

Disclosures: The authors report no relevant financial disclosures.

The AAP updated its clinical recommendations for autism spectrum disorder, or ASD, for the first time in 12 years, emphasizing the importance of early detection and intervention strategies and describing concomitant conditions like anxiety and ADHD.

ASD affects one in 59 children in the United States. Since the previous ASD recommendations were published in 2007, “the body of research supporting evidence-based interventions has grown substantially,” the AAP said. The updated guidance “reflects this new evidence and offers recommendations to physicians in identifying and managing the disorder, and in treating common co-occurring conditions.”

“We know that the earlier we can start therapies for children who show signs of developmental delays, the better likelihood of positive outcomes,” Susan L. Hyman, MD, FAAP, developmental and behavioral pediatrician at the University of Rochester and Golisano Children’s Hospital, said in a news release. “There is no reason to wait for a diagnosis of autism before starting some services, such as speech or behavioral therapies. Interventions work best when they are early, when they are intense and when they involve the family.”

Direct and indirect costs of caring for children and adults with ASD in the U.S. were estimated to be $268 billion in 2015, Hyman and colleagues noted in the new clinical report, which was published in Pediatrics. They said lifetime costs for education, health and other necessary services can range from $1.4 to $2.4 million.

Increasing rates of ASD diagnoses can likely be attributed to broader diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, increased public awareness of ASD and its symptoms, recommendations for universal screening and increased availability for early intervention and school-based services for children with ASD, Hyman and colleagues said.

The report includes the following updated recommendations for pediatricians, as summarized by the AAP:

  • Conduct developmental and behavioral surveillance during all well visits with children, including developmental screening at 9, 18 and 30 months, and standardized screening for ASD at 18 and 24 months;
  • Help ensure children with ASD are provided with evidence-based services to address behavioral, social and academic needs at home and school, with access to appropriate pediatric and mental health care, leisure activities and respite services;
  • Engage with families and youth to plan the transition into the adult medical and behavioral care system; and
  • Inform families and patients about the evidence for interventions, and refer families for possible participation in clinical research and support organizations.

“There needs to be more equitable and affordable therapies for all families, from the time of diagnosis through employment and adult life,” Hyman said. “All children deserve options and hope for productive, satisfying lives.”

Disclosures: The authors report no relevant financial disclosures.