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5 tests not to order for an autistic child


By Cara Murez
Health Day reporter

MONDAY, June 21, 2021 (HealthDay News) – A leading medical group is offering testing guidelines for children with autistic behaviors.

The American Academy of Pediatrics Council on Environmental Health has pointed out that some measurements for testing chemical exposure are not helpful in guiding treatment. The council stressed that just because a chemical is found in the body does not mean that it will cause harm.

The council proposed a list of five things doctors and patients should question when evaluating tests for children with behavioral or developmental disorders, including autism. They include:

Tests for metals and minerals: Routine testing for metals and minerals can be harmful if those results guide treatment, the council said, as exposures have not been conclusively linked to the development of autistic behaviors.

The advice referred to some preservatives used in multidose vaccine vials – thimerosal and ethyl mercury – which have been blamed for the increased rates of autism without evidence of a causal link.

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“As the symptoms of autism appear early in childhood and possibly months or years after a potential exposure may have resulted in neurotoxicity, the likelihood of the continued presence of such a toxicant is low,” said the board.

But parents may be desperate for answers and look for alternative sources that recommend lab testing for minerals and metals, the council said. “The discovery of an abnormal result has led to misguided treatment and the death of some patients,” the council said in a press release.

Hair analyzes: The council also advised against ordering hair tests for environmental toxins in children with behavioral or developmental disorders, saying they have no scientific basis.

Mold test: The council said mold sensitivity tests should not be ordered for patients without clear symptoms of allergy or asthma, especially those with chronic fatigue, joint stiffness, mental (“cognitive”) problems. and affective disorders.

For people with allergy or asthma symptoms who have not responded to efforts to reduce exposure to allergens, mold sensitivity testing may be performed by an allergist or pulmonologist, but should not be done routinely as part of primary care, the advice added.

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“Mold can cause sensitization and clinical disease. Skin and in vitro testing can effectively identify patients sensitized to mold, although this does not always result in clinical disease. The results of these tests should be interpreted in the context of the patient’s clinical presentation. , said the board.

Urine analysis : The council also advised against ordering a “chelation challenge” urinalysis for children suspected of lead poisoning. There is some evidence that it is no more useful than a standard blood lead test and can be dangerous.

Blood tests: With the exception of some heavy metals, such as lead, measurements of environmental chemicals in a person’s blood or urine should not be used to make clinical decisions, the council said.

“It is virtually impossible for people not to come into contact with hundreds of chemicals every day, whether these chemicals are in our food, our air, our water, our soil, our dust or the products we use. . And it’s even more difficult for people to know whether these chemicals are harmful to their health or not, ”the council said. “Presence doesn’t mean toxicity.”

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Separate studies are needed to determine if blood or urine levels are causing disease. Units specializing in pediatric environmental health can provide additional information on the indications, measurement and interpretation of environmental chemicals in blood or urine, the council suggested.

More information

The US Centers for Disease Control and Prevention has more on autism spectrum disorders.

SOURCE: American Academy of Pediatrics Council on Environmental Health, press release, May 17, 2021

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