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. 2016 Sep:176:182-94.
doi: 10.1016/j.jpeds.2016.06.004. Epub 2016 Jul 12.

To Screen or Not to Screen Universally for Autism is not the Question: Why the Task Force Got It Wrong

Karen Pierce  1 , Eric Courchesne  2 , Elizabeth Bacon  2
Affiliations

To Screen or Not to Screen Universally for Autism is not the Question: Why the Task Force Got It Wrong

Karen Pierce et al. J Pediatr. 2016 Sep.
No abstract available

Keywords: ASD; US Preventive Services Task Force; autism; brain development; early detection; early identification; early treatment; ethics; general population-based studies; screening.

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Conflict of interest statement

Conflicts of Interest: There are no conflicts of interest, real or perceived, for any of the authors. The funding agency had no role in the conception or writing of this manuscript.

Figures

Figure 1
Figure 1
Overview of key features of USPSTF ASD Screening Recommendation Statement.
Figure 2
Figure 2
Illustration of the balance of potential benefits and harms of engaging in universal early screening for ASD. As illustrated in the figure, the potential benefits outweigh potential harm.
Figure 3
Figure 3
Areas of known (B,C) and theoretical (A, D) improvement following early intervention. Early detection enables services to begin sooner which in turn leads to many areas of change for a child with ASD and their family. Early treatment can impact family functioning, the child’s cognitive and adaptive functioning, social communication and interaction, and ultimately long-term outcome.
Figure 4
Figure 4
Golgi-stained sections highlighting the size and dendtric arborization of brain cells in the anterior portion of the middle frontal gyrus at different ages. As illustrated in the figure, the normal newborn has sparse neural circuitry, and then, with increasing age, there is a tremendous increase in the complexity of neural circuitry that is illustrated by the great increase of dendritic arbors from birth to 2 years. The figure highlights the ideal age for intervention might be prior to 2 years. The figure also highlights that most ASD children start treatment well after much circuitry is already formed. Adapted from Courchesne and Pierce (2005a) which was previously adapted from Nolte (1993), whose figure combined panels from Conel, 1939; 1941, 1951 and 1959.
See this image and copyright information in PMC

Comment in

  • The necessity of early intervention in autism.
    Lazaratou H, Economou M, Dikeos D. Lazaratou H, et al. J Pediatr. 2017 May;184:240-241. doi: 10.1016/j.jpeds.2016.12.030. Epub 2016 Dec 28. J Pediatr. 2017. PMID: 28038765 No abstract available.

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