MedicalResearch.com Interview with:
Dr. David Grossman MD MPH
Vice chair of the U.S. Preventive Services Task Force
Professor at the University of Washington Schools of Public Health and Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Grossman: The Task Force cares deeply about the challenges that children affected by autism and their families face in getting the care and support they need. This was the first time that we assessed the evidence around screening young children for autism, and our recommendation was informed by a review of the most up-to-date science, which included randomized trials, observational studies, and research from a number of Federal health agencies. We concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for autism spectrum disorder in children for whom no concerns of autism have been raised by their parents or a clinician. This is an I statement, which is not a recommendation against screening, but a call for more research on screening and treatment in young children who don’t have obvious symptoms. It is important to note that this recommendation will not affect insurance coverage for autism screening, which is currently covered under the Affordable Care Act as a result of the American Academy of Pediatrics’ Bright Futures Guidelines.
Medical Research: What should clinicians and patients take away from your report?
Dr. Grossman: The recommendation reflects the fact that the current evidence is insufficient to assess the balance of benefits and harms of screening for autism in children for whom concerns of autism have been raised by their parents or a clinician. Until more research is completed, clinicians should use their judgment to determine how often screening should occur as well as the best treatment options for individual patients, based on personal risk factors, other behavioral health conditions, and life events. In all, we are hopeful that this recommendation will further inform clinicians on the benefits and harms of screening; the accuracy of screening tests used in primary care; and the benefits and harms of different interventions. Additionally, we hope this recommendation will further encourage parents who have concerns to speak to their child’s doctor to determine the most appropriate course of action. Doctors and other health care professionals who care for children should listen to parents’ concerns and use proven tools to assess the need for further testing and services.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Grossman: To date, autism research has appropriately focused on treatment for children who have significant symptoms. The Task Force found that more research is needed on the impact of screening and treatment in very young children whose parents or doctor have not noticed any symptoms. These types of studies will allow us to ultimately make a recommendation about whether or not to screen children with no signs or symptoms of autism, an important next step to helping all children. Until this research is available, we respect our colleagues’ expert opinions and believe doctors should use their clinical judgment when deciding when and whom to screen for autism.
Medical Research: Is there anything else you would like to add?
Dr. Grossman: It’s important to remember that this is not a recommendation against screening, but a call for more research. Additionally, parents who have any concerns about their child’s development should tell their child’s doctor, and those children should receive appropriate follow-up care.
Siu AL, and the US Preventive Services Task Force (USPSTF). Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement. JAMA.2016;315(7):691-696. doi:10.1001/jama.2016.0018.
Dr. David Grossman (2016). Guidelines for Autism Screening Require More Research