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Eye Tracking Young Children with Autism
Published on: March 27, 2012
Appropriate investigations for clinical care versus research in children with autism
1Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. rapin@aecom.yu.edu
Insights
Autism Spectrum Disorder (ASD) lacks a definitive medical test. Medical evaluations aim to identify treatable conditions like epilepsy, guiding targeted interventions for individuals with ASD.
Area of Science:
- Neurodevelopmental Disorders
- Medical Diagnostics
Background:
- Autism Spectrum Disorder (ASD) is defined by behavior, lacking a specific medical diagnostic test.
- Medical evaluations for ASD focus on identifying co-occurring conditions and potential etiologies.
Purpose of the Study:
- To outline key elements of history, examination, and laboratory testing for informative clinical evaluations in ASD.
- To differentiate between routine clinical practice and research protocols regarding diagnostic testing in ASD.
Main Methods:
- Review of clinical history elements relevant to ASD diagnosis.
- Guidelines for physical examination findings in individuals with ASD.
- Criteria for selecting informative laboratory tests for ASD evaluations.
Main Results:
- Specific etiologies or syndromes are identified in a minority of individuals with ASD.
- Clinical evaluations should prioritize targeted testing based on specific indications.
Conclusions:
- Medical evaluations for ASD should focus on identifying treatable conditions like epilepsy or behavioral issues.
- Extensive, non-specific laboratory testing is discouraged in clinical practice due to cost and invasiveness, unlike in research settings.
Abstract:
As disorders on the autistic spectrum are behaviorally defined, there is no medical test to diagnose autism. The purpose of a medical evaluation is to detect particular etiologies, and manifestations like clinical or subclinical epilepsy or behavior problems that might mandate pharmacologic intervention. Defining a unique syndrome or genetic etiology may benefit other family members, although, currently, specific causes are detectable in only a small minority of individuals on the autistic spectrum. The paper lists elements of the history, examination, and laboratory testing most likely to be informative in clinical practice. Ordering large numbers of tests in the absence of a specific clinical indication is not recommended because it is invasive, wasteful and unlikely to generate useful data. This is not true, of course, in the context of a hypothesis-driven, approved research protocol where collecting standardized data and applying the most up-to-date research technologies is appropriate.
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