Undiagnosed Autism and Developmental Delay in Children with Epilepsy

Research presented today at the American Epilepsy Society's 65^th annual meeting suggest that systematic screening for developmental delay (DD) and autism should be routine for all children seen in epilepsy clinics.

Investigators at Children's Memorial Hospital, Chicago, evaluated the potential of giving screening questionnaires to parents of pediatric epilepsy patients seen in an epilepsy monitoring unit (EMU) and a keotgenic diet clinic. More than 75% of the children screen positive for developmental delay, 41% of them with autism.

Although many of the cases had been previously diagnosed, 36% of the children did not have a prior DD or autism diagnosis and were referred for further confirmatory evaluation. These children had potential delays or autism, and were either not receiving therapy in that area or the therapy was not adequate. They were given appropriate referrals to physical therapy, speech therapy, occupational therapy, and psychiatric services including psychiatrics, psychologists, and social workers or an educational specialist.

The study was conducted among children under age five seen between November 1, 2010 and May 15, 2011. Parents were asked to complete the developmental screening instrument (Ages and Stages Questionnaire, ASQ) and one of two autism screening instruments used in the study. No child screened positive for autism alone.

According to Anne Berg and Breanne Fisher of the investigative team, "The yield of screening in the EMU setting for developmental and behavioral co-morbidities is sufficiently high to support routine screening of both new onset and established cases of pediatric epilepsy."

"We recommend that everyone should be screened… We as practitioners should make it a priority to screen, referral, and follow up on any positive findings," said Breanne Fisher, who noted that screening children for developmental delay and autism could be done at any epilepsy centers or clinics.

The goal of screening is to catch potential developmental delays or autism early on in order to provide the necessary therapies. Anne Berg suspects that pediatricians think neurologists are screening for autism or developmental delay and the neurologists believe pediatricians are screening, which creates a gap in services. They aim to eradicate that gap.

The investigators have now focused the program on evaluating the prospective use of a move extensive battery of screening tools with new-onset patients followed over time.

Featured in the photo is (from left to right) Breanne Fisher, Catherine Dezort, and Anne Berg.
Photo taken by Shelly Williams