The first challenge that we face in doing so is the lack of any kind of medical test to confirm the autistic disorder. You just can’t pull blood from all children at birth and test them genetically. The diagnosis is predominantly based on the observations about the development and behavioral traits of a child, thus it becomes impossible to detect such ailment before the child attains a specific age that is more than 18 years. The reason being there has been a lot of physiological variation that one can expect in the usual or normal development of a child. Developmental delay has been a common occurrence, and is not known to cause any major obstacle in the overall growth of the child – mentally, physically or otherwise. Thus, just because a child does not start communicating till 1 year of age, may not be autism in making.
Yet another problem faced by the pediatricians is the lack of awareness in the parental community about autistic disorders – especially regarding the various forms of it. Autism is still considered an equivalent or just another form of mental retardation by most of the people. Thus if a child fails to communicate, or keep an eye contact, it will not be reported to the pediatrician immediately, thinking it just a part of slow speech development. When the child does not take interest in social interactions, it can be mis-understood as a moodiness or shyness, instead of looking at it as a possible autistic trait. Denial also plays a significant role, thus rejecting the possibility, even if the awareness about autistic traits is made.
To avoid this, every child should be screened for developmental delays and disabilities at regular intervals of 9 months, 18 months and 24-30 months of their age. Additional visits can be arranged if the child shows some traits other than the normal ones. The children who give a history of preterm birth, or low birth weight, or having a sibling with an ASD should be screened more thoroughly and frequently, including an educational session with the parents or guardians or care-takers to understand what to expect, and what not.
The child can be further directed to comprehensive diagnostic evaluation, if shows positive signs of any traits characterizing ASDs. It can be done by developmental pediatricians, child neurologists and finally child psychologists, for refined problem definition and management planning.
To conclude, I would repeat the motto – earlier we define the problem, healthier we can resolve it.