Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorderwith reported prevalence in the United States of 1 in 59 children
(approximately 1.7%). Core deficits are identified in 2 domains: social
communication/interaction and restrictive, repetitive patterns of behavior.
Children and youth with ASD have service needs in behavioral, educational,
health, leisure, family support, and other areas. Standardized screening for
ASD at 18 and 24 months of age with ongoing developmental surveillance
continues to be recommended in primary care (although it may be performed
in other settings), because ASD is common, can be diagnosed as young as
18 months of age, and has evidenced-based interventions that may improve
function. More accurate and culturally sensitive screening approaches are
needed. Primary care providers should be familiar with the diagnostic criteria
for ASD, appropriate etiologic evaluation, and co-occurring medical and
behavioral conditions (such as disorders of sleep and feeding, gastrointestinal
tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder,
anxiety, and wandering) that affect the child’s function and quality of life. There
is an increasing evidence base to support behavioral and other interventions
to address specific skills and symptoms. Shared decision making calls for
collaboration with families in evaluation and choice of interventions. This
single clinical report updates the 2007 American Academy of Pediatrics
clinical reports on the evaluation and treatment of ASD in one publication with
an online table of contents and section view available through the American
Academy of Pediatrics Gateway to help the reader identify topic areas within
the report.