The early ASD screening debate continues

Dr Jessica Edwards

Jessica received her MA in Biological Sciences and her DPhil in Neurobehavioural Genetics from the University of Oxford (Magdalen College). After completing her post-doctoral research, she moved into scientific editing and publishing, first working for Spandidos Publications (London, UK) and then moving to Nature Publishing Group. Jessica is now a freelance editor and science writer, and started writing for “The Bridge” in December 2017.

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The debate about screening and providing early treatment for young children with, or with high likelihood of, autism spectrum disorder (ASD) is ongoing, but limited data are available to support either side of the argument. Now, a systematic review of randomised controlled trials (RCTs) of interventions for children ≤6 years with (or with high likelihood of) ASD has concluded that the available data is currently insufficient to support the argument for early intervention.

The review identified 48 RCTs, the majority of which were published post 2010 (83%) and were undertaken in the USA. Most of these studies had a small sample size (<100 participants) and only six studies met the criteria for low risk of bias. Common issues included lack of blinding of outcome assessment and failure to specify a method of allocation concealment. Unfortunately, wide differences in the demographics of the sample population, the treatment model (n=32) and the “dose” of treatment and the outcome measures used (n=87) between these 48 RCTs made meta-analyses difficult.

Despite the heightened interest over the past decade in evaluating early interventions in ASD, the researchers conclude that improved trial design and co-ordination of future RCTs is required before an accurate evaluation can be made.

French, L. & Kennedy, E. M . M. (2017), Research Review: Early intervention for infants and young children with, or at-risk of, autism spectrum disorder: a systematic review. J Child Psychol Psychiatr. doi:10.1111/jcpp.12828

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It would be helpful to have a description of what ‘ Early Intervention’ is and what the treatment is and to know if there are any other studies, which are not RCTs, which demonstrate qualitatively the benefits or not for the child and his/her family and his/her education.

Also, what are the risks of Early Intervention’, if any, for the child? Does ‘At risk of ASD’ mean the unborn sibling of a child with ASD ? It would be helpful to see research from the parents, carers and teachers perspective, on the benefits of Early Intervention’ too.

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