![]() In the 12 years since the American Academy of Pediatrics (AAP) published the clinical report “Identification and Evaluation of Children With Autism Spectrum Disorders” 5 and its companion, “Management of Children With Autism Spectrum Disorders,” 6 reported prevalence rates of ASD in children have increased, understanding of potential risk factors has expanded, awareness of co-occurring medical conditions and genetic contribution to etiology has improved, and the body of research supporting evidence-based interventions has grown substantially. ASD is more commonly diagnosed now than in the past, and the significant health, educational, and social needs of individuals with ASD and their families constitute an area of critical need for resources, research, and professional education. 4 To deliver timely and effective medical, behavioral, educational, and social services across the lifespan means that primary care providers must understand the needs of individuals with ASD and their families. 3 The lifetime cost of education, health, and other service needs for an individual with ASD ranges from $1.4 to $2.4 million dollars, depending on whether he or she has any co-occurring intellectual disabilities. Direct and indirect costs of caring for children and adults with ASD in the United States in 2015 were estimated to be $268 billion, more than the cost of stroke and hypertension combined. 2 The care needs of children with ASD are significant, affect parents and siblings as well, and require substantial community resources. 1 ASD affects more than 5 million Americans, with an estimated prevalence of approximately 1.7% in children. 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.Īutism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by social and communication impairment and restricted or repetitive behaviors. Shared decision making calls for collaboration with families in evaluation and choice of interventions. ![]() There is an increasing evidence base to support behavioral and other interventions to address specific skills and symptoms. Primary care providers should be familiar with the diagnosticcriteria 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. More accurate and culturally sensitive screening approaches are needed. 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. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Core deficits are identified in 2 domains: social communication/interaction and restrictive, repetitive patterns of behavior. Dr Hyman got no personal reimbursement from the company the funding was for staff time for recruitment and assessment and clinical research center support for the trial.Īutism spectrum disorder (ASD) is a common neurodevelopmental disorder with reported prevalence in the United States of 1 in 59 children (approximately 1.7%). Funding was for the staff to complete the assessments required for the clinical trial. University of Rochester will be leaving the trial in 2019 (withdrawal submitted) because of staffing, and that reimbursement for staff time does not cover the cost of participation. The University of Rochester (Dr Hyman’s institution) was 1 of >40 sites and had 2 study participants in 2018. Dr Hyman is the site principal investigator of a clinical trial of a novel agent being tested to promote social function in patients with autism. Her years of relationship with the company are 2015 to the present. Once it is studied and marketed (if appropriate), Dr Levy will (possibly in the future) earn some money. This application is the focus of a National Institutes of Health R21 grant, for which Dr Levy is funded for ∼2% of her salary. Dr Levy has not received any money yet from this company. This application is being developed to assist in nutritional and dietary management of children with autism. Dr Levy is on the advisory board for the application’s development. POTENTIAL CONFLICT OF INTEREST: MeMix LLC is a company that makes an application (for phones). ![]()
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