Autistic Spectrum Disorders occur as often as 6 cases per 1000. Thus every pediatrician will have a number of autistic children in a practice. Physicians who evaluate children who present with symptoms suggesting ADHD should be alert to additional behavioral traits suggesting autism. Also, many children with Autism also have ADHD.
Current surveillance and developmental screening recommendations are to perform surveillance for these disorders at each visit for children under age 6 years including reviewing family history for ASD and addressing parent concerns. ASD specific screening tools such as the M-CHAT should be administered at ages18 and 24 months.
The four criteria for Autism are below. Details for each can be found in the DSM-IV
1. Qualitative impairment in social interaction (ex: impairment of nonverbal behaviors, peer relationships, lack of sharing of interests and social or emotional reciprocity.
2. Qualitative impairments in communication by delayed or lack of spoken language, impaired conversational skills, stereotypical or idiosyncratic language lack of make-believe or imitative play.
3. Repetitive or stereotyped patterns of behavior, interests or activities, such as preoccupation with restricted interests, inflexible adherence to specific routines, stereotyped motor mannerisms.
4. Onset before age 3 years
Where diagnostic uncertainty exists, children should be referred for further diagnostic workup to a behavioral health professional experienced with autism.