Autism spectrum disorder
Also known as: ASD · autism
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Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
American Academy of Pediatrics (AAP) · 2020 · 2020 clinical report
The AAP's current comprehensive guidance for paediatricians on identifying, evaluating and managing children with autism spectrum disorder. It was the organisation's first full update in roughly a decade and covers screening and surveillance, diagnostic evaluation, genetic and medical workup, co-occurring conditions, and evidence-based interventions, with an emphasis on shared decision-making with families. This is an AAP clinical report rather than a formally graded practice guideline. Linked via PubMed because the publisher's site blocks automated access.
- Supports standardised ASD screening at 18 and 24 months alongside ongoing developmental surveillance in primary care. source
- Addresses co-occurring problems including sleep, feeding, gastrointestinal symptoms, seizures, ADHD, anxiety and wandering. source
- Published in Pediatrics 2020;145(1):e20193447. source
Autism spectrum disorder in under 19s: support and management
NICE (UK) · 2013 · CG170
UK national guidance on supporting and managing autism in children and young people from birth to age 18, including general principles of care, family support, autism-specific interventions, management of behaviour that challenges, life-skills development, transition to adult services, and interventions that should not be used. Published 2013, last updated June 2021. Separate NICE guidance covers recognition and diagnosis, and autism in adults.
US vs EU key differences
- Screening policy differs: the AAP report reaffirms universal standardised autism screening at 18 and 24 months in primary care alongside ongoing developmental surveillance, while the NICE support-and-management guideline sets out no universal population screening programme. source
- NICE states explicitly that antipsychotics, antidepressants and anticonvulsants should not be used to treat the core features of autism, restricting antipsychotics to challenging behaviour with review at 3-4 weeks and discontinuation by 6 weeks if there is no response. source
- NICE names specific unproven therapies to avoid, including gluten- or casein-free exclusion diets, secretin, chelation, hyperbaric oxygen and neurofeedback, a list of explicit 'do not use' statements the US clinical report does not frame the same way. source
- Version currency differs: the AAP clinical report was published in 2020, while NICE CG170 dates to 2013. source
What changed recently
- US2007 clinical reports → 2020 clinical report2020-01-01
The 2020 clinical report consolidates the two separate 2007 AAP reports on evaluation and on management into a single document and reframes practice around acting before a formal diagnosis, urging developmental surveillance at every well-child visit and autism-specific screening at 18 and 24 months with intervention started for identified delays without waiting for diagnostic confirmation. It also updates prevalence, genetic contributions, co-occurring medical and behavioural conditions, and the evidence base for interventions accumulated since 2007.
source ↗curation confidence 90%
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