Autism Spectrum Disorder | American Academy of Pediatrics


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  1. Melissa Long, MD*
  2. Kelly Register-Brown, MD, MSc†
  1. *Department of General and Community Pediatrics
  2. †Department of Psychiatry and Behavioral Sciences, Children’s National Hospital, Washington, DC,
  • Abbreviations:
    AAP:
    American Academy of Pediatrics
    ABA:
    Applied behavior analysis
    ADHD:
    Attention Deficit Hyperactivity Disorder
    ASD:
    Autism Spectrum Disorder
    CBD:
    Cannabidiol
    CDC:
    Centers for Disease Control and Prevention
    COVID-19:
    Coronavirus disease 2019
    DSM-5:
    Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
    EEG:
    electroencephalogram
    FDA:
    Food and Drug Administration
    I WOULD:
    limited intellect
    MCHAT-R / F:
    Modified Checklist for Autism in Young Children, revised, with follow-up
  • Practice gap

    With the increasing prevalence of Autism Spectrum Disorders (ASD) and a lack of specialists in diagnosis and treatment, pediatricians increasingly need to be satisfied with 1) making a preliminary diagnosis of ASD in order to gain access to critical early behavioral interventions, 2) the Comorbidities that significantly impair quality of life and 3) help families to find their way around the increasingly complex network of ASA-related services.

    aims

    After completing this article, readers should be able to:

    1. Assess how prevalence data will evolve over time and identify the disparities that exist in the diagnosis based on race and gender.

    2. Recognize the heterogeneity of the clinical presentation of Autism Spectrum Disorder (ASD) as a function of the child’s age, gender, and developmental abilities.

    3. Understand the diagnostic criteria for ASA.

    4. Differentiate findings related to ASD from isolated speech and language delays, intellectual disability, and profound hearing loss.

    5. Determine age-appropriate screening for ASD and be ready to discuss the results and next steps with families.

    6. Plan appropriate management of the core symptoms of ASA and identify the most common medical and psychiatric comorbidities with ASA.

    7. Realize the complexities of care coordination required to support families of children with ASD and the importance of advocating for a pediatric medical home.

    Epidemiology

    Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by differences in social and communicative functions as well as restricted and repetitive behaviors and interests. The increasing prevalence of ASA has been the subject of intense attention in the medical literature and the lay press. In the United States, the Centers for Disease Control and Prevention (CDC) Autism and Developmental Disability Monitoring Network, which measures confirmed diagnoses of ASD, found an increased prevalence of ASD in 8-year-old US children of 1 in 150 in 2000 by 2002 to 1 in 54 in 2016. (1) Reasons for the observed increase in ASA prevalence are probably increased screenings …

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