Should all children be screened for autism? It depends who you ask

Kathleen Blanchard's picture
Autism screening questioned.

Researchers at odds about routine screening for autism

The American Academy of Pediatrics recently put forth recommendations that health practitioners make autism screening a part of regular pediatric checkups, regardless of whether symptoms are present.

But a new study, published in the journal Pediatrics, suggests screening routinely for autism may cause more harm than good.

Researchers from McMaster University say there is “not enough sound evidence to support the implementation of a routine population-based screening program for autism.”

According to Dr. Jan Willem Gorter, a researcher in McMaster’s CanChild Centre for Childhood Disability Research and associate professor of pediatrics, there is also no evidence that routine screening would do more good than harm.

Increasing rates of autism prompted recommendations for routine screening for which Gorter also points out there is no good screening method or treatment.

For the study, the researchers conducted a review of literature to determine whether autism screening in the community is effective. Gorter said no programs have been studied in randomized clinical trials to show their effectiveness, unlike breast cancer screening.


The researchers say, “None of the autism screening tests currently available has been shown to be able to fulfill the properties of accuracy, namely high sensitivity, high specificity, and high predictive value (proportion of patients with positive test results who are diagnosed correctly) in a population-wide screening program” , leading Gorter to the conclusion that recommendations for autism screening from the American Academy of Pediatrics lacks solid evidence for implementation.

Autism cases on the rise

Autism cases have increased dramatically in the past three decades, affecting 11 per 1000 school age children – up from 0.8 cases per 1000.

The disorder affects communication and motor skills and sometimes intellectual development.

The researchers say their study is a “call to action” that shows screening for autism in the community lacks evidence of benefit. They suggest only children who display language difficulties or social and cognitive problems should be assessed for the disorder.

Contrary to recommendations from the American Academy of Pediatrics (AAP), who say that all children should be screened for autism spectrum disorder at 18 months and at 24 months of age, researchers at McMaster University say clinical evidence is lacking that the practice would do more good than harm, negating the position statement from the AAP.

Pediatrics: DOI: 10.1542/peds.2010-1881
"Early Autism Detection: Are We Ready for Routine Screening?"
Mona Al-Qabandi, Jan Willem Gorter and Peter Rosenbau

Image credit: Morguefile