There have been 12 years since the American Academy of Pediatrics (AAP) issued the last documentation regarding autism. The new autism guidelines emphasize the importance of early, intensive, and family-centered diagnosis and treatment.
The New Autism Guidelines: What Do They Bring to the Table?
The new autism guidelines issued on December 16 encourages doctors to identify at-risk children as early as possible and offer them the intense care they need. The updated report, published in the journal Pediatrics, comes with new data on the prevalence of autism. It also aligns the diagnosis guidelines with the DSM-5 (published in 2013).
The report also represents a scientific update on risk factors, genes that contribute to autism, co-morbidity, and types of interventions that work best.
One of the most important upgrades since the last report in 2007 is, however, the urgency of early diagnosis and intervention. The new autism guidelines urge doctors and health care providers to check for autism-related issues during all well-baby visits.
They should also refer children to treatment at the earliest sign of a developmental disorder instead of waiting for a formal autism investigation and diagnosis.
Highlights of the New Autism Guidelines for Doctors
Among the highlights of this report, experts noticed the following:
- The report urges pediatricians and health care providers to guide families toward scientifically-based interventions;
- Doctors should also steer families away from treatments with a poor or absent scientific background and pseudo-scientific explanations;
- Doctors should screen and treat babies for co-morbid disorders that usually occur together with ASD: intellectual disabilities, anxiety disorders, ADHD, sleep and feeding disorders, language impairments, seizures, or gastrointestinal symptomatology.
Treating Autism Should Be a Team Effort
One of the most important aspects of the new autism guidelines issued by the AAP is the “team effort” concept. While not new in practice, it is good to finally see reports aligning with what practitioners have been telling for years. The early diagnosis and treatment of a child with ASD should involve the affected individual, pediatricians, specialty doctors, infant psychiatrists, the school, the family, and the community itself.
According to the update, no matter if the intervention focuses on social, speech, or motor rehabilitation, the treatment is more successful if it is “early, intense, and involves the family.”
The report also recommends the use of medical homes and chronic care models involving both healthcare and communal systems. One of the biggest challenges for people with ASD and their families is the transition to adulthood and the gain of independent life skills.
According to report’s first author Susan Hyman, MD, of the University of Rochester in New York,
“There has been a lot of research regarding the treatment of co-occurring medical conditions in the medical home. There has also been research that demonstrates families are more satisfied with medical care when it occurs in medical homes and children with autism truly have a chronic illness that needs to be addressed with the medical home model.”
The New Autism Guidelines and Perspectives for the Future
The AAP endorsed the Interagency Autism Coordinating Committee of the National Institutes of Health plan to up their ante when it comes to ASD research. This includes improving the understanding of the disorder’s origin and new treatment strategies via clinical trials.
Limitations in understanding ASD exist to this day and pseudoscience, together with misinformation, does not help. The world needs more research focused on:
- autism’s closely-related disorders,
- ASD prognosis in different populations,
- the validity of screening tests in children 30 months old and older,
- and the success rate of several established or less established interventions and therapies, among others.
Moreover, the new autism guidelines recommend clinicians and all other health care professionals to assist families in preparing their kids for postsecondary education and public programs as they transition into adulthood and strive for independence.
However, children and parents dealing with ASD are not of the woods yet. While the new guidelines sound excellent on paper, the harsh truth is these children and their families still encounter bureaucratic chaos, with some private insurance companies denying coverage, with loose federal guidelines, and with services not available to older children. State laws across the U.S. are uneven when it comes to coverage, services, and programs – to the detriment of the affected individuals, their families, and their community.
However, given that in the U.S. the prevalence of autism is now 1 in 59 children (as compared to 2007’s 1 in 155), scientists, doctors, and policymakers should get on the same page. Let’s hope this happens sooner rather than later.
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