PEDIATRICS Vol. 120 No. 5 November 2007, pp. 1183-1215 (doi:10.1542/peds.2007-2361)
CLINICAL REPORT |
Identification and Evaluation of Children With Autism Spectrum Disorders
Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs, they will most likely raise their concerns to their child's pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics. This clinical report is 1 of 2 documents that replace the original American Academy of Pediatrics policy statement and technical report published in 2001. This report addresses background information, including definition, history, epidemiology, diagnostic criteria, early signs, neuropathologic aspects, and etiologic possibilities in autism spectrum disorders. In addition, this report provides an algorithm to help the pediatrician develop a strategy for early identification of children with autism spectrum disorders. The accompanying clinical report addresses the management of children with autism spectrum disorders and follows this report on page 1162 [available at www.pediatrics.org/cgi/content/full/120/5/1162]. Both clinical reports are complemented by the toolkit titled "Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians," which contains screening and surveillance tools, practical forms, tables, and parent handouts to assist the pediatrician in the identification, evaluation, and management of autism spectrum disorders in children.
Key Words: autism • autism spectrum disorders • Asperger syndrome • pervasive developmental disorders • fragile X syndrome • joint attention • self-injurious behaviors • theory of mind • neuropathologic abnormalities
Abbreviations: ASD—autism spectrum disorder • AD—autistic disorder • DSM—Diagnostic and Statistical Manual of Mental Disorders • AS—Asperger syndrome • PDD-NOS—pervasive developmental disorder–not otherwise specified • PCP—primary care pediatrician • AAP—American Academy of Pediatrics • IDEA—Individuals With Disabilities Education Act • MR—mental retardation • GDD—global developmental delay • ADHD—attention-deficit/hyperactivity disorder • FISH—fluorescence in situ hybridization • MMR—measles-mumps-rubella • JA—joint attention • ToM—theory of mind • SLP—speech-language pathologist • CHAT—Checklist for Autism in Toddlers • M-CHAT, Modified Checklist for Autism in Toddlers • CAST—Childhood Asperger Syndrome Test • EEG—electroencephalography
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