Ignore the Bad Advice — All Kids Need Autism Screening
Universal screening for autism improves the lives of kids with autism spectrum disorders (ASD) and other developmentaldisorders. This practice needs to continue uninterrupted, despite astatement the United States Preventative Services Task Force made recently in JAMA. Established in 1984, USPSTF is an independent, volunteer-run panel of national experts who make recommendations that affect the health of Americans with conditions treated by different fields of medicine.
Recently, the group evaluated published, peer-review studies to determine whether there was enough evidence to bless this practice. In August 2015, USPSTF released its preliminary recommendation, which was actually no recommendation at all. Instead, USPSTF stated that there was “insufficient evidence” to endorse screening for all children, meaning the practice got an “I” rating. The factor that weighed the most heavily on this decision was the lack of a randomized control trial that could reveal whether screening improved outcomes.
Here’s how such a study would work: Researchers would select a group of kids, at random, from a group and refer them for screening. The same researchers would also randomly select another group oftoddlers from this same group and make sure they were not screened. Then, all kids would be tracked for a number of years to determine the effect of screening on longer term outcome. Given that the American Academy of Pediatrics (AAP) already endorses screeningfor autism spectrum disorder at 18 and 24 months, such a study would be unethical. But even if this unethical design could be implemented, scientists would have to then follow these children for up to seven years to determine their outcomes
Alycia Halladay has been involved in autism research for the past 15 years. After completing a Ph.D. in psychology at Rutgers University, she became a post-doctoral fellow in the university’s Department of Pharmacology and Toxicology working with scientists developing the first animal models of autism spectrum disorders. In 2005 she became an associate director of research at the National Alliance for Autism Research, which has since merged with Autism Speaks. Alycia continues to hold and adjunct position at Rutgers University. In September of 2014, Alycia became the first chief science officer of the Autism Science Foundation. As part of the ASF team, she continues her commitment to brain tissue research, research targeting the risk factors for autism spectrum disorders, studies of differences between men and women with autism, and importantly, support of junior level investigators just beginning a career in autism.