The latest study released by the U.S. Preventive Services Task Force has sparked anger among medical professionals and concerned parents.
In a bit of surreally bad timing, the latest study released by the U.S. Preventive Services Task Force has sparked anger among medical professionals and concerned parents across the spectrum — and especially in the Philadelphia Jewish community, which is currently taking part in Jewish Disability Awareness and Inclusion Month.
On Feb. 16, the task force announced there is insufficient evidence to recommend for or against screening for autism spectrum disorder (ASD) in children 18 to 30 months old for whom no concerns of ASD have been raised by their parents or a clinician. The Task Force’s recommendation is not a rejection, rather, a call for more research.
Medical professionals Wendy Ross, Alyson Simpson and Jamie Bassman disagree with the task force’s findings.
“When I saw this piece come out, I was just blown away,” said Bassman, an occupational therapist.
The American Academy of Pediatricians (AAP) agrees with the task force’s assertion that more research is needed on the impact of screening and interventions for children who have autism, especially those in early childhood.
“The AAP stands behind its recommendation that all children be screened for ASD at ages 18 and 24 months, along with regular developmental surveillance,” the group maintained in a statement.
The task force is funded by the federal Agency for Healthcare Research and Quality. It is a volunteer panel of medical experts that makes recommendations about clinical preventive services for the U.S. Congress in order to highlight areas that deserve more research funding.
In 2010, it was estimated one in 68 children had autism in the United States. According to the Centers for Disease Control and Prevention, parents of children with ASD often notice developmental problems before the child’s first birthday. Children can show signs of differences in social, communication and fine motor skills as early as 6 months.
According to the Autism Treatment Center of America, an advocacy group located in Sheffield, Mass., these are some signs that may indicate a child has a developmental disorder:
• An unusual insistence on routine
• A preference for being alone or aloofness
• A resistance to being held or touched
• Spinning objects or unusual sensory interests in objects (e.g. peering at objects, sniffing or licking non-food items, watching objects fall)
• Engaging in repetitious motor movements (e.g. running in circles, jumping more than usual)
• Repeating words or phrases
• Laughing, crying or showing distress for no apparent reason
• No response to verbal instructions despite normal hearing test
Bassman, a member of Congregation Beth Am Israel in Penn Valley, works with infants and toddlers with special needs. She stressed that the task force’s findings should be taken with a grain of salt, noting that this is the same group that recommended women need fewer breast screenings in October 2015.
“Pediatricians could really benefit from more training on questions to ask parents,” Bassman said, adding that if a parent doesn’t advocate for their child, a doctor may not always suggest the child get tested.
Ross, a developmental pediatrician, is the director of the Center for Pediatric Development in Bryn Mawr and founder of the nonprofit Autism Inclusion Resources, which helps families affected by autism learn how to successfully navigate different types of social situations.
“I was surprised that there was even a question about screening it,” Ross said. “We do know that early intervention is helpful. From my perspective, there are lots of kids that fall through the cracks.”
Ross acknowledged that while not all children are talking at 18 months, if a child isn’t responding to their name by then, it is indicative of developmental issues. Screenings at 18 months and then a year or two later can only benefit the child, she added.
“I think the key is to screen early because you want to make sure you are not missing anything,” Ross explained.
However, Ross said, developmental diseases are more common than physical ailments. “I think it’s much easier and better to be proactive than reactive — the truth is, it’s much better to give a kid help than to wait.”
Alyson Simpson, a member of Temple Har Zion in Penn Valley, is a certified allergist, immunologist and pediatrician with offices in Conshohocken and Lansdale. Her son, Jacob, 6, is autistic.
She spoke with the Exponent about how crucial it is for children to get screened as early as 18 months. Her son was initially evaluated around 21 months and had a 50 percent social and receptive language delay. He would only say goodbye occasionally, did not follow one-step commands, respond to his name or point to his body parts appropriately at school.
Through early intervention, his receptive language skills normalized within six months through activities, Sesame Street-themed felt books and paint-by-number watercolors.
Early prevention for Jacob made a difference in his life: Today, he is in a typical kindergarten setting at Gladwyne Elementary and enjoys the Simpsons, Superman, Legos, lacrosse and soccer.
And for those who argue that the task force’s recommendation is being done in the name of saving money, Simpson doesn’t hesitate to debunk that line of reasoning. “The increased productivity and decreased supports required by children who successfully respond to early intervention services will save society billions,” she said.
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