How Good are Early Detection Methods for Autism

Autism diagnosis is appearing in very young children but how accurate is a diagnosis for a toddler

(RxWiki News) Early diagnosis can give parents access to interventions and treatments to improve outcomes for children with autism. How young an age can doctors be sure of a diagnosis, and are incorrect diagnoses harmful?

Autism is diagnosed by looking at behaviors and language of children. There is a push for early diagnosis so children get the best chance of success, but current methods of diagnosis are limited.

When children are tested before age 3, they may be more likely to get a diagnosis of autism when they actually have another type of developmental delay.

"Tell a pediatrician about any concerns for your child’s development"

Two recent studies highlight some of the issues and potential problems with diagnosing autism at very young ages.

A study led by Mieke Dereu, PhD, of the University of Ghent in Belgium, looked at the ability of the Checklist for Early Signs of Developmental Disorders (CESDD) and the Early Screening of Autistic Traits questionnaire (ESAT) to diagnose autism in children at the age of 2.

They compared language and social skills of children who were diagnosed with autism at age 2 to their language and social skills on the same tests when the children were 4 years old.

The tests were likely to catch and diagnose children with autism but also children with other developmental delays.

Another test, the Autism Diagnostic Observation Schedule, was needed at age 4 to determine which children had a true diagnosis of autism and which had other developmental difficulties.

A different study, led by Lisa Wiggins, PhD, of the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, looked at 1,392 children that were part of the Autism and Developmental Disabilities Monitoring Network between 2000 and 2006. 

They looked to see how many children were diagnosed with autism but later had their diagnosis changed. 

They found that about 4 percent of the children in the study had a change in diagnosis and that being first diagnosed with autism before age 2 1/2 was linked with a change in diagnosis.

Both studies concluded that diagnosis at an early age is more prone to error. More false positives are likely – children being diagnosed with autism that actually have some other developmental issue.

dailyRx spoke with psychiatrist Glenn Elliot about the potential harm that may come from false positives and early diagnosis. He warned that children under age 3 are in various stages of language and social development, which makes accurate diagnosis at this age very difficult.

Dr. Elliot noted that cost and psychological factors of false diagnosis are concerns.  Parents and school systems may spend large amounts of money giving an intervention to a child that does not need it – or needs something different. 

“Also, you have parents thinking their child has a disorder that he/she does not, which has its own psychic costs,” he stated.

The Dereu and colleagues report was published online ahead of print in May in European Child and Adolescent Psychiatry. Wiggins’ paper was published online ahead of print in May in the Journal of Developmental & Behavioral Pediatrics. No conflicts of interest were disclosed.

Review Date: 
May 15, 2012