New Guidelines Promise Earlier Identification of Autism
CDC/ICDL Working Group Releases New Report during Autism Awareness Month
Washington, D.C., April 23, 2007 (ICDL) – Leading experts on child development today presented a new framework for identifying children at risk of Autism Spectrum Disorders (ASD) and other developmental challenges, saying that current guidelines fail to identify many children who need and would benefit from early intervention.
The framework is contained in a report by a special working group formed by the Centers for Disease Control (CDC) and the Interdisciplinary Council on Developmental Learning Disorders (ICDL), co-chaired by Dr. José Cordero, former Director of the CDC's National Center on Birth Defects and Developmental Disabilities and currently Dean of the School of Public Health of the University of Puerto Rico, and Dr. Stanley Greenspan, chair of the ICDL.
The framework presents newly formulated indicators to identify at-risk children in the first and second years of life, components for a comprehensive evaluation of infants and children determined to be at risk, and essential elements of a successful early intervention program for ASD and other developmental disorders.
The authors say the new rubric casts a wider net than current common practice in an effort to identify all children at risk of developmental disabilities.
"Children identified with developmental or behavioral disabilities earlier have a better chance of reaching their full potential," said Dr. Cordero. "We believe this framework improves our ability to identify infants, young children, and families at risk and to organize truly comprehensive, developmentally-based intervention efforts."
The CDC-ICDL framework is based on current understanding of healthy developmental patterns and is designed to detect all possible deviations from those patterns. It uses risk indicators designed to detect a lack of mastery of age-expected emotional, social, and cognitive milestones during a child's first 2 years of life. These include the inability to:
* Be calm and focus on sights and sounds by 2 months of age
* Initiate and sustain warm, joyful interactions with caregivers by 4 months of age
* Exchange emotional and social gestures (using different sounds), reaching, exchanging, back-and-forth smiling, looking, and searching by 8-9 months of age
* Engage in shared social problem-solving and playing, including taking a caregiver's hand to find a toy or favorite food; playing with a toy and caregiver together with lots of back-and-forth exchanges of sounds; and social gestures such as smiles, looks, and pointing by 12-16 months of age.
Early identification and preventive intervention for ASD and other developmental disorders have been long-standing goals, yet until now there has been no widely accepted framework for determining which infants and young children are at risk and the best ways to intervene. The new framework is intended to fill that gap to help more infants and young children overcome early challenges and acquire the foundations for healthy emotional, social, and intellectual development.
"This report is important to the future of children and families all over the country," said Dr. T. Berry Brazelton, founder of the Child Development Unit at Children's Hospital Boston and the Touchpoints Center and member of the CDC-ICDL Working Group. "Without it, many adults would be thrust on our society with untreated autism that might have been effectively treated had intervention been started early in their childhood. We know that the earlier in childhood --or even in infancy-- treatment begins, the more likely people affected by autism can adapt to society and the workplace."
Work group members included: Co-Chairs - José F. Cordero, M.D., M.P.H. (former Director, National Center on Birth Defects and Developmental Disabilities – CDC) and Stanley I. Greenspan, M.D. (Chair, Interdisciplinary Council on Developmental and Learning Disorders). Members - Margaret L. Bauman, M.D. (Massachusetts General Hospital), T. Berry Brazelton, M.D. (Harvard Medical School), Geraldine Dawson, Ph.D. (University of Washington), Barbara Dunbar, Ph.D. (Georgia State University), Peter C. Mundy, Ph.D. (University of Miami), Ruth Perou, Ph.D. (National Center on Birth Defects and Developmental Disabilities – CDC), Keith G. Scott, Ph.D. (University of Miami), Stuart G. Shanker, D.Phil. (York University, Toronto, Canada), and Ruth E. K. Stein, M.D. (Children's Hospital at Montefiore).
The Interdisciplinary Council on Developmental and Learning Disorders (ICDL) is a non-profit organization dedicated to improving the prevention, assessment, diagnosis, and treatment of emotional and developmental disorders in infancy and childhood by promoting dialogue and integrating knowledge from different disciplines.
For the complete report and more information, please visit www.icdl.com or contact Cecilia Breinbauer, M.D., M.P.H. at cbreinbauer@icdl.com
