Babies, Bathwater, and Screening for Autism Spectrum Disorder: Comments on the USPSTF Recommendations for Autism...

Area of Science:

• Pediatrics
• Developmental Psychology
• Public Health

Background:

• Current guidelines advocate for universal developmental screening and autism spectrum disorder (ASD) screening at 18 and 24 months.
• A draft recommendation questions the evidence supporting this practice, citing insufficient data.
• The broader benefits of developmental surveillance and screening are often overlooked.

Purpose of the Study:

• To evaluate the evidence for developmental screening at 18 and 24 months.
• To consider the comprehensive benefits of developmental surveillance beyond specific disorder screening.
• To advocate for the continuation of periodic formal developmental screening in primary care.

Main Methods:

• Review of current guidelines and evidence for developmental screening.
• Analysis of the assumptions underlying screening recommendations.
• Consideration of benefits associated with routine developmental surveillance.

Main Results:

• The United States Preventive Services Task Force found insufficient evidence to support universal ASD screening at 18 and 24 months.
• Periodic formal screening offers benefits beyond the detection of specific developmental disorders.
• The value of developmental surveillance as a continuous process is highlighted.

Conclusions:

• Primary care clinicians should continue formal developmental screening at established intervals.
• Developmental screening provides broader benefits than solely identifying autism spectrum disorders.
• Advocacy for continued screening supports early detection and intervention.