Many children may be diagnosed with autism years too late to benefit from early behavioral intervention, according to 2011 national survey findings released Thursday from the National Institute of Mental Health.
Intensive behavioral therapy for autism, which can begin as early as age two, can significantly improve language and thinking skills in children with autism, according to the National Institutes of Health. The therapy, which helps develop a child's social and behavior skills within different environments, is considered among the best forms of treatment by the American Academy of Pediatrics.
However, the survey found that more than half of children had reached age five before they were first identified as having an autism spectrum disorder.
Although children can continue to benefit from behavioral interventions after age five, earlier behavioral intervention is associated with better outcomes, according to many experts.
"It is critical that we address the barriers that are preventing children from receiving early intervention," said Geraldine Dawson, chief science officer of Autism Speaks, who was not involved in the study.
More than 1400 children ages 6 to 17 with autism were included in the survey. The survey looked at diagnosis of the disorder within the last 17 years.
The older children may have been receiving some sort of medical assessment for their condition before receiving a formal diagnosis, according to Lisa Colpe, chief officer of clinical and population epidemiology research at the National Institute of Mental Health's and co-author of the study.
"It's still a very complex disorder to diagnose and does take some time," said Colpe. "These ages mean that they have been getting assessed for some period of time before getting a diagnosed."
Ninety percent of the children diagnosed participated in some form of developmental service including occupational therapy, speech and language therapy, and social skills training, according to the study. However, fewer than half of the children underwent behavioral therapy.
A diagnosis of autism spectrum disorder can take five different forms, ranging from mild to severe. Because the report did not specify what forms of autism were diagnosed within the spectrum, it's unclear what the appropriate intervention would have been for the children included in the survey.
The survey also found that more than half of the children diagnosed with an autism spectrum disorder use psychotropic medications including antipsychotics, anti-depressants, stimulants, and mood stabilizers.
These medications are approved to treat irritability in some children with autism, and in many cases are used in conjunction with other therapies that address major symptoms of the disorder, including communication issues and repetitive behaviors.
General physicians and psychologists were most likely able to pick up the child's diagnosis if they were under age five. Children over age five were most likely diagnosed by a psychologist or psychiatrist.
Children age five and older were over half as likely to be diagnosed with autism when reviewed by a panel of doctors as opposed to a single doctor or psychologist making a diagnosis.
"Depending on the age, it's a different specialist that they're encountering," said Colpe.
The findings call for physicians to screen all children for autism once at 18 months, and once again at age two, said Dawson. Since parents are able to spot changes in their children, Dawson said addressing any concerns as early as possible can also be key to early intervention.
"Parents who are concerned that their child has autism should bring those concerns immediately to a health care professional, such as their pediatrician," said Dawson, adding that pediatricians are often the gateway doctor for many children.