“‘What’s the scoop with our autism screening?’ a concerned mother asked the nurse upon realizing that the autism spectrum disorder screening questionnaire she had completed wasn’t addressed during her daughter’s well-child visit. The nurse brought the mother’s concern to the primary care provider, who replied, ‘Don’t worry, I only look at screenings if I think there’s a problem. I can spot autism during a patient visit.’”
Is this provider’s confident claim a realistic one? Almost certainly not, as will become clear to anyone who reads the CE articles on autism spectrum disorder (ASD) in the October (“From the CDC: Understanding Autism Spectrum Disorder“) and November (“Autism Spectrum Disorder: The Nurse’s Role“) issues of AJN. As a result of such casual attitudes toward screening, many autistic children are almost certainly not receiving the early treatment and monitoring that can make a big difference in their quality of life.
Delayed diagnosis reduces the window for effective interventions.
ASD is the most common developmental disability in the United States, yet according to the November CE article, screening rates across the U.S. range from a low of 17.2% in Mississippi to a high of less than 60% in Oregon. And while ASD can be reliably diagnosed before the age of two, most diagnoses are made after a child is four years old—this lengthy delay reduces the period for effective interventions. A child’s brain grows rapidly and is particularly “neuroplastic” before the age of two, making interventions most likely to be optimally effective when the disorder is diagnosed early.
The critical role played by nurses.
“Nurses often play a critical role in surveillance, coordination, and championing the efforts of the health care team,” write the authors of the October CE, which addresses risk factors for ASD, its epidemiology, common concurrent conditions, evaluation, diagnosis, treatments, and outcomes. In many settings, nurses are in a central position to ensure that ASD-specific screening and developmental surveillance are done, to elicit parents’ concerns, and to ensure access to services.
To learn more about ASD, as well as about the best resources for clinicians and families, read one or both of these CE articles; CE articles in AJN are free to read.
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