Quality vs. Quantity in an autism diagnosis

In the fight to ensure everyone with autism is detected and diagnosed as early as possible, community providers are sometimes pushed to the limit in what they can do.  They have a huge caseload and there are long waitlists.  So how accurate are autism diagnoses given by these providers with little time and little resources for training?  As it turns out, they are just okay.  Approximately 23% of those diagnosed by community providers were not diagnosed using standardized and validated autism tools.  How can we weigh this potential over and mis-diagnosis with the potential for missing individuals with autism and depriving them of interventions and services?  That’s a topic for another discussion.  However, one question on the cause of autism was addressed and a theory debunked:  autism is not caused by caesarean section deliveries altering the microbiome, and then leading to ASD.  The microbiome may be involved, but not because of method of delivery and use of antibiotic medications.

https://www.ncbi.nlm.nih.gov/pubmed/30270970

https://www.ncbi.nlm.nih.gov/pubmed/30273187

 

Betsy DeVos, autism screening and testosterone – in that order

This week two studies which examined infants and younger children that will significantly advance understanding of causes and services for people with autism were published.  After a commentary about the confirmation of Betsy DeVos, the study that used a practical methodology to improve autism screening in pediatrics clinic from researchers at Duke University was presented.  After that, some early results from the EARLI study  which examined pregnancies in families where an older sibling was diagnosed was presented.  In this study, Bo Park and her colleagues at Drexel University, Johns Hopkins University, University of California at Davis and Kaiser Permanente show that testosterone levels in pregnancy aren’t related to later autism symptoms unless the older sibling affected is a girl.  These findings can illustrate why girls are less likely to be diagnosed with autism compared to boys.  The study is open access and can be downloaded here, thanks to the journal Molecular Autism:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282802/pdf/13229_2017_Article_118.pdf

 

13229_2017_118_Fig3_HTML