Links To And Excerpts From The Canadian Paediatric Society’s “Early detection for autism spectrum disorder in young children”

Here are links to the three Canadian Paediatric Society’s position statements on Autism:

In this post, I link to and excerpt from The Canadian Paediatric Society‘s Early detection for autism spectrum disorder in young children, Paediatr Child Health 2019 24(7):424–432.

All that follows is from the above resource.


Autism spectrum disorder (ASD) is a life-long neurodevelopmental disorder, characterized by impairments in social communication, repetitive, restricted patterns of behaviour, and unusual sensory sensitivities or interests. ASD significantly impacts the lives of children and their families. Currently, the estimated prevalence of ASD is 1 in 66 Canadians aged 5 to 17 years. General paediatricians, family physicians, and other health care professionals are, therefore, seeing more children with ASD in their practices. The timely diagnosis of ASD, and referral for intensive behavioural and educational interventions at the earliest age possible, may lead to better long-term outcomes by capitalizing on the brain’s neuroplasticity at younger ages. This statement provides clear, comprehensive, evidence-informed recommendations and tools to help community paediatricians and other primary care providers monitor for the earliest signs of ASD—an important step toward an accurate diagnosis and comprehensive needs assessment for intervention planning.

Keywords: Autism spectrum disorder; Developmental surveillance; Early identification; Screening



The prevalence of ASD has increased, from an estimated 1 in 1,000 children in Nova Scotia, an example cited 30 years ago [2], to a current estimate of 1 in 66 Canadians aged 5 to 17 years (1 in 42 males, and 1 in 165 females) [3]. The degree to which rising ASD prevalence is due to a true increase in cases is not yet known. Improved detection and diagnosis, and the broadening of diagnostic criteria with successive versions of the DSM, are likely contributors to changes in prevalence estimates [4]. Evidence suggests that ASD can be reliably diagnosed by 2 years of age in some children [5], though subtler cases may not present fully until later. Despite increasing awareness of early signs, the mean age of diagnosis remains 4 to 5 years of age [6]. While males are diagnosed with ASD four times more frequently than females [4][5], the sex gap may be narrowing. Recognition is growing that some girls present with more subtle signs than boys [7][9].

Etiology and risk factors

The etiology of ASD is not completely understood, though recent findings suggest an interplay among genetic, epigenetic, and environmental factors [10]. Strong risk factors for ASD include male sex and positive family history. Recurrence risk estimates for younger siblings of children with ASD range from 7% to 19% [11][12] versus 1.5% in the general population [4]. Recurrence varies by degree of familial relatedness. One recent Swedish study indicated a tenfold increase in relative risk when a full sibling has been diagnosed with ASD, as compared with a twofold increase when a cousin is affected [13]. Other risk factors are summarized in Table 2 [10][19]. The mechanisms associated with environmental exposure and ASD may include inflammation, oxidative stress, endocrine disruption and may be influenced by gene-related effects [15][16].

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