Should we target early diagnosis in autism? Maybe…

An article titled “The urgent need to shorten autism’s diagnostic odyssey” has been published on the blog. It’s a heartfelt plea for earlier diagnosis,  to enable early intervention, and help families to access support when they need it.
I see all that,  but a headlong rush to earlier diagnosis would have its disadvantages. 
1) looking too hard for ASD in children during the first few years runs the risk of mass over-diagnosis, with its attendant harms, I shudder when people advocate universal screening, so poor is the accuracy of these tools
2) early intervention is desirable,  but the results are modest,  and good quality work on communication and interaction should NOT be dependant on formal diagnosis. Sadly,  in insurance based systems like the US, it often is.
3) a system of screening followed up by formal assessment would require a massive injection of resources,  which would mainly be spent excluding ASD in screen-positive children. Anything that diverts resources from supporting children and families should be avoided.

So yes,  address concerns early with robust support for the child’s presenting difficulties,  but rushing millions of children to unnecessary assessment would help no-one.


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