Routine screening for autism may be unwarranted

Al-Qabandi M. Pediatrics. 2011;doi:10.1542/peds.2010-1881.

There is probably “not enough sound evidence to support the implementation of a routine population-based screening program for autism,” despite recommendations by the American Academy of Pediatrics to the contrary, according to a study published online recently.

Not only are there no good screening tools or effective treatments, but there is no evidence yet that routine screening does more good than harm, said Jan Willem Gorter, MD, PhD, of the CanChild Centre for Childhood Disability Research at McMaster University in Canada and associate professor of pediatrics.

For the study, McMaster researchers conducted a literature search to assess the effectiveness of community screening programs for autism.

In a press release about the study, Gorter said no autism screening programs have been studied in randomized controlled trials.

“None of the autism screening tests for the general population that we have today have proven accuracy,” Gorter said. “That is, they aren’t good enough to accurately detect children who have autism or to accurately detect those who don’t.”

Gorter and colleagues recommended careful surveillance and assessment of all preschoolers who show signs of language, social and cognitive problems.

During the past 3 decades, the prevalence of autism has risen to 11 cases per 1,000 school-aged children from 0.8 cases per 1,000. Reasons for this increase vary, according to the researchers, including: improved detection, changes in diagnosing the disorder or an actual increase. The disorder is more common in males, with a 4:1 male-to-female ratio.

Disclosure: The researchers report no relevant financial disclosures.

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