New Autism Recommendation Sparks Debate

[AGXStarseed]

(Not written by me)



WASHINGTON (AP) — A government task force says more research is needed to determine if toddlers should be screened for autism even if check-ups or parents haven’t spotted developmental problems — despite guidelines from other health groups that urge such screening.

Doctors are supposed to routinely check if youngsters are meeting appropriate milestones or show signs of developmental disorders including autism. And specialists say parents should immediately point out any concerns, such as whether a child doesn’t make eye contact, so they can receive appropriate diagnostic testing.

Monday’s draft recommendation addresses another step, whether doctors also should use parent questionnaires and similar tools to screen for autism in children under 3 who have no obvious symptoms.

The U.S. Preventive Services Task Force said there’s insufficient evidence to recommend either for or against so-called universal screening, and that doctors should use their own judgment until more research is in.

While early treatment is promising for the more severely affected, that hasn’t been studied in children who have mild symptoms that may be caught only in screening, said task force vice chairman and pediatrician Dr. David Grossman. Other questions include what age to screen, and what tool to use.

“We’re not saying it’s the wrong thing. We’re just saying we’re not sure,” Grossman said.

The American Academy of Pediatrics said the recommendation runs counter to its own guideline that all children be screened at ages 18 months and 24 months, in addition to standard developmental checks. Other health groups also support screening.

“You identify the kids early, you get them to treatment early, and the outcome is better,” said Dr. Susan E. Levy of the Children’s Hospital of Philadelphia and AAP’s autism subcommittee.

The task force’s draft recommendation is open for public comment for 30 days.



SOURCE: https://www.yahoo.com/parenting/new-autism-recommendation-sparks-debate-125927036387.html

 

[Nadador]

This is an interesting proposition. Intriguing to consider what it might do to current public perception of the autism spectrum.

I have to wonder what is meant by "mild symptoms," as the standing American diagnostic criteria won't recognise much that isn't quite pronounced, as it is. Have we come to a place where we're redefining 'mild'? I thought that was Asperger's, which is why it was rendered clinically obsolete.

 

[ancusmitis]

We need an objective definition of "improvement" as well as stricter ethical guidelines for so-called "treatment" before we start with this early screening business.

 

[Carnelian]

We need an objective definition of "improvement" as well as stricter ethical guidelines for so-called "treatment" before we start with this early screening business.

That's what I was thinking. So many "treatments" are detrimental to the child.

 

[Nadador]

We need an objective definition of "improvement" as well as stricter ethical guidelines for so-called "treatment" before we start with this early screening business.

That's what I was thinking. So many "treatments" are detrimental to the child.

Given the 'authority' to which They might turn for guidance on this [or at least would lobby them for input], I'm a bit concerned as well, bearing in mind that we, here, may not be the best arbiters of what is appropriate to the population that would require the most intervention. I always have to remind myself that the brand of autism which is the focus of public concern is about as alien to me as neurotypicality.

 

[ancusmitis]

Given the 'authority' to which They might turn for guidance on this [or at least would lobby them for input], I'm a bit concerned as well, bearing in mind that we, here, may not be the best arbiters of what is appropriate to the population that would require the most intervention. I always have to remind myself that the brand of autism which is the focus of public concern is about as alien to me as neurotypicality.

I think a lot of the ambiguity is wildly overstated. Bringing back corporal punishment because students have "behavior problems" comes to mind. Some of us were NT and some of us were not.

We live in a culture that believes in solving problems with force. People like us can stand up and say, "Stop it, that hurts."
"Okay," they tell us, "But you're not them and you don't know that it would be as bad for them as it was for you." When your base assumption is that force is appropriate, then any lack of (or even mere insufficiency of) disproof is taken as positive proof of effectiveness. Even when there is no proof that it is beneficial.

Some things, there just isn't any amount of searching that will find you someone for whom it is appropriate.

 

[Nadador]

I think a lot of the ambiguity is wildly overstated.

Some things, there just isn't any amount of searching that will find you someone for whom it is appropriate.

Ambiguity? Just clarifying.

Agreed on your conclusional statement. My only sticking point is that the most widely-practised therapies seem sensible, and kind enough to the child [though I don't like the prescribed length of certain intensive sessions for an autistic]. The 'force' that is often most troubling to me, personally, comes from parents who impose NT expectations on clinically unidentified autistic children.

One advantage of universal screening and [tiered] treatment recommendations would be universal standards, which could be much better than what often happens now, and would be subject to more scrutiny and oversight. So, I'm not instinctively opposed to the idea...just cautious.

In reality, it's unlikely that milder identified cases would be subject to many recommendations, anyway. We are, at the heart of it, still talking about money, here.

 

[ancusmitis]

Ambiguity? Just clarifying.

Probably not the right word. Obfuscation, more like. The idea that because someone is in category X, then it's okay to do Y to them even though it would be clearly immoral for anyone else. "Some kids just got to be treated differently. I know it seems brutal to you, but they aren't normal like you are." Stuff like that.

I don't know what therapies are in widest use, to be honest, but I've heard about some of them. Aversives are still making the rounds, last I heard. Restraint and isolation are time-honored traditions, they're still around. Can't trust people when they say they'll "only use them when necessary." Because of the fact they are an option, they start getting used punitively. Of course, they'll never call it punitive. It's "therapy."

 

[Nadador]

I don't know what therapies are in widest use, to be honest, but I've heard about some of them. Aversives are still making the rounds, last I heard. Restraint and isolation are time-honored traditions, they're still around. Can't trust people when they say they'll "only use them when necessary." Because of the fact they are an option, they start getting used punitively. Of course, they'll never call it punitive. It's "therapy."

Ah, I see what you mean. Thanks.

I have no love for the source, but here is a fairly comprehensive list of current methods for your information.

Aversives seem to have given way to positive-reinforcement-or-no-response, which is good. You won't find the AAP approving restraints or isolation, as their journal has featured many an article decrying such tactics. This circles round to my point about better scrutiny and oversight if screening becomes universalised. What I would really like to see with this is special licensure for approved practitioners. Some hope.