Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
Pediatrics
Hyman, S. L., Levy, S. E., et al. (2020).
Pediatrics, 145(1), 1-71.
This is a guideline providing consensus recommendations on the identification, evaluation, and management, of children on the autism spectrum disorder. This guideline builds upon previous reports including Johnson and Myers (2007) and Myers and Johnson (2007). For more information, please see Notes on This Article.
American Academy of Pediatrics
This guideline builds upon the 2007 reports below:
"Children with language delay or inattention to language should have an evaluation of their hearing as part of their initial evaluation…. appropriate amplification should be offered, if indicated" (p. 14).
Children on the autism spectrum "should have documentation of specific coexisting speech and language diagnoses so that appropriate intervention might be provided" (p. 26).
"Valid assessment of cognitive and language ability is an important component of the diagnostic evaluation" (p. 14). At the time of diagnosis, a formal assessment of communication should include the following:
<ul>
<li>expressive language skills;</li>
<li>receptive language skills; and</li>
<li>pragmatic language skills.</li>
</ul>
The American Academy of Pediatrics does not have recommendations for the universal screening for autism spectrum disorder in children older than 30 months and there are currently no validated screening tools available to use in pediatric practice.
"The pediatrician may refer the child for private speech-language therapy if he or she is not eligible for services in school or if increased intensity of intervention is desired" (p. 26).
"The [American Academy of Pediatrics] AAP recommends screening all children for symptoms of [autism spectrum disorder] ASD through a combination of developmental surveillance at all visits and standardized autism-specific screening tests at 18 and 24 months of age in their primary care visits" (p. 7).
"When children do not spontaneously speak, augmentative and alternative communication (AAC) may be introduced. Examples of AAC strategies include sign language, the Picture Exchange Communication System, and speech-generating devices" (p. 26).
"Current scientific evidence does not support the use of facilitated communication in which a nonverbal individual is guided to communicate" (p. 26).
"School-aged students with spoken language should have their pragmatic language assessed as part of their school-related reevaluations, with consideration of pragmatic language testing if academic problems and inattention are noted in the classroom" (p. 26).
"Teaching and coaching social interaction involves both behavioral therapy and speech and language therapy approaches" (p. 25). Social skills support in school and other therapeutic settings should be considered for children on the autism spectrum, including those with typical academic skills.
<div>Speech or occupational therapy assessment is indicated if oral motor concerns during feeding are observed, such as delayed oral motor feeding development, food refusal, or impact on nutrition.</div>
