This is the response to the recent article “Why There’s Disagreement over Screening Every Child for Autism?” published in The New York Times. The latest recommendations of the US Preventive Services Task Force (USPSTF) state that the universal screening of all autistic children should not be conducted. The article highlights that this decision made many people, especially parents, worry about children’s health.
It is noted by Carroll (2015), the author of the article, that pediatricians are now directed by the evidence-based practice guidelines that prioritize early diagnosis as the key factor of effective treatment. The author’s approach to criticizing the USPSTF’s decision seems to be relevant and thought-provoking since the given four answers allow for considering the problem of childhood autism in a detailed manner. In particular, the role of cost-effectiveness, prevalence, early diagnosis, and using information related to the target disease promote a productive public dialogue.
The article provides evidence-based facts and statistics, which supports the author’s assumptions. It is reported that out of 68 children, 1 has autism, while the Modified Checklist for Autism in Toddlers (M-CHAT), a free questionnaire, is a feasible tool to screen patients. Indeed, this shows that screening for the disease does not require significant spending, and a lot of children may remain non-diagnosed on time.
Carroll (2015) reasonably argues that the intervention examined by the mentioned agency was tested on children with autism, yet those whose disease was identified due to screening were not targeted specifically. In other words, it would be more appropriate if the study focused on children with no or unnoticed symptoms, whose disorder was revealed due to universal screening. In this connection, one may claim that the results of research need to be re-verified or, at least, adjusted according to the needs of the early treatment of autism.
Similar concerns are also expressed by several studies that prioritize the potential of universal screening in autism detection during childhood. Dawson (2016), who reviewed the recommendations of the USPSTF, claims that universal screening is likely to lead to universal diagnosis; however, it is noted that screening per se is not regarded as the intervention promoting better outcomes. Consistent with Carroll (2015), Dawson (2016) also pinpoints that a new study would require significant funding and time as it should involve a large representative group of participants. A range of other studies, including those by Herlihy et al. (2014) and Mitchell and Holdt (2014) emphasize that the developmental delay can be easily revealed based on parents’ analysis of their child’s behaviors and completion of the M-CHAT.
The available evidence demonstrates that universal autism screening is beneficial to reduce racial and ethnic disparities in access to autism identification and treatment. Mitchell and Holdt (2014) state that African American and Hispanic children show lower rates of timely diagnosis, which makes the problem even more resonant. In the mentioned populations, the increasing prevalence of autism can be mitigated by means of universal screening, which is also pertinent to other ethnicities. Thus, from the ethical point of view, universal screening of all children for autism is the best option to ensure their equal access to care services and proper life quality. In the era when prevention is declared a paramount goal, cost-effective, feasible, and evidence-based universal screening is a way to help many children improve their lives.
References
Carroll, A. E. (2015). Why there’s disagreement over screening every child for autism? The New York Times. Web.
Dawson, G. (2016). Why it’s important to continue universal autism screening while research fully examines its impact. JAMA Pediatrics, 170(6), 527-528.
Herlihy, L. E., Brooks, B., Dumont-Mathieu, T., Barton, M. L., Fein, D., Chen, C. M., & Robins, D. L. (2014). Standardized screening facilitates timely diagnosis of autism spectrum disorders in a diverse sample of low-risk toddlers. Journal of Developmental and Behavioral Pediatrics, 35(2), 85-92.
Mitchell, C., & Holdt, N. (2014). The search for a timely diagnosis: Parents’ experiences of their child being diagnosed with an Autistic Spectrum Disorder. Journal of Child & Adolescent Mental Health, 26(1), 49-62.