Children With Autism Now Diagnosed at Younger Ages

Children with autism spectrum disorder who were born prior to the 2007 American Academy of Pediatrics (AAP) recommendation that all children be screened for autism at the 18- and 24-month well-child visits were diagnosed significantly later than they are today, a new study found. The new AAP policy may therefore help identify children with autism sooner so they can benefit from early intervention, say researchers Maria Valicenti-McDermott, MD, MS, and colleagues at Montefiore Medical Center/Albert Einstein College of Medicine in New York.

However, the US Preventive Services Task Force recently concluded that there is not enough evidence to recommend universal autism screening of young children for whom no concerns about autism spectrum disorder have been raised by their parents or clinician.

The researchers compared 2 groups of ethnically diverse children initially diagnosed with autism spectrum disorder who were born between 2003 and 2012 at a university-affiliated development center: those born before 2005, prior to universal autism screening recommendations, and those born in 2005 or later, who would have been of an age to undergo autism screening by 24 months of age based on the 2007 AAP recommendation. The average age at autism diagnosis for those born before 2005 was just under 4 years of age (46 ± 15 months); for those born during or after 2005, it was approximately 2-and-a-half years old (31 ± 12 months).

The percentage of children diagnosed with autism after age 3 decreased from 63% to 26% in the group born before 2005—a decline seen across all ethnic groups. The association between autism diagnosis after age 3 and birth before 2005 was significant even after adjusting for demographics and clinical characteristics.

Valicenti-McDermott said the children evaluated prior to the 2007 AAP recommendation of universal autism screening were more likely to be diagnosed at an older age and with more severe autistic symptoms and more impaired adaptive functioning—a critical finding because research has shown the significant impact of early intervention for children with autism spectrum disorder.

The researchers said additional study is needed to confirm the effectiveness of early universal autism screening. It remains unclear whether the significant drop in average age of diagnosis was entirely the result of universal screening or the effect of the national campaign to increase awareness of autism spectrum disorder in general and the importance of early diagnosis in particular. Valicenti-McDermott and her colleagues point out that Latino and African American children are already being diagnosed later and families may be less aware of autism spectrum disorder.

The study, “Age of Diagnosis of Autism Spectrum Disorder in an Ethnically Diverse Population Before and after the 2007 AAP Recommendation for Universal Screening,” was presented at the Pediatric Academic Societies 2016 Meeting in Baltimore on May 1.