Autism Spectrum Disorder is a widely-affecting and rapidly-growing disorder, currently affecting one in sixty-eight children (Autism Speaks). Autism is one of the fastest-growing disorders in America and can cost a family an average of $60,000 a year solely on medical costs (Autism Speaks). These facts indicate how big of a problem autism is, so what exactly is autism? The Mayo Clinic defines Autism Spectrum Disorder as a serious neurodevelopmental disorder that impairs a child's ability to communicate and interact with others. It also includes restricted repetitive behaviors, interests and activities, causing significant impairment in social, occupational and other areas of functioning (Mayo Clinic). Autism screening is the process where a child would potentially be diagnosed with the disease. This screening usually occurs during well-child check-up visits, where a doctor will check to make sure a child has met all of their developmental milestones (CDC). If a child is suspected to possibly have autism, they are then sent to child neurologists or psychologists for further screening (CDC). Though it is recommended by the CDC that all children should be screened for autism, it is not mandatory. This means that some children go without screening and could potentially have autism but not know it. Those affected by autism typically need therapy and special needs, so those who are unaware of their disease are greatly affected in a negative way. Autism is a disease that has been a part in my life for as long as I can remember. I was exposed to this disease early on in my life due to cousins, friends and neighbors being affected with autism. Throughout my life I was always interested in helping and understanding those with developmental disorders. In high school, I was offered an opportunity to work with the special needs program, which I accepted excitedly. After working with these kids, I discovered my passion for those with special needs. I began babysitting and working one-on-one with a particular child with severe autism named Thomas. Working with Thomas every day gave me first-hand knowledge on autism: how it works, affects the child, and how to deal with it. Thomas is eleven years old but has the brain development and functionality of about a five-year-old. He needs many special accommodations and medical attention to be able to function properly. Luckily for Thomas, his autism was recognized and diagnosed early on in his life, which gave him immediate access to the care and accommodations that he needs. Unfortunately, this is not the case for each child affected by autism. Currently, screening for Autism Spectrum Disorder is not mandatory for all children, meaning that children could go far into their lives without knowing they suffer from autism. These children are deprived from the necessary care and accommodations that they need and thus are entitled to a poorer quality of life. With Thomas being diagnosed early in life, he is given a chance at the highest quality of life possible and is provided the care he needs. All children should be given this equal opportunity. I have discovered by working with those with autism that knowledge is key. Knowing what exactly a child suffers from and how to approach and deal with it is important, especially when working with those who have speech and communication problems. Without a doctor to properly screen and diagnose a child with autism, children can go undiagnosed and untreated solely due to parents not knowing what autism is. By looking at the astounding rate of those affected by autism, (one in sixty-eight children,) one can see what a real and pressing issue that this disorder truly is in our world today (Autism Speaks). With so many children being diagnosed with autism, it is imperative that some kind of medium is put in place to try and benefit those who have autism. By making autism screening mandatory for all children, those affected will be guaranteed a proper diagnosis in a timely manner and will lessen the number of children who go through life without knowing they suffer from the disorder. 

Autism screening becoming mandatory is supported by many big names, including Autism Speaks, CDC, The American Academy of Physicians, as well as President Barack Obama (Autism Speaks). President Obama has called for universal screening and rescreening for all children because children are currently screened only if children or pediatricians voice a concern, causing those who are affected yet undiagnosed to involuntarily fall behind others (Chicago Tribune).  The Centers for Disease Control and Prevention has declared that autism spectrum disorders are an "urgent public health concern" and recommends screening for all children (CDC). By having each and every child screened for autism, the potential for early treatment is offered, which can greatly lessen the effects of the condition (Lipkin). Benard Dreyer, president of the American Academy of Physicians, claims that, "we know from a lot of research that the earlier you can intervene with any developmental problem -- including autism -- the better off the child is. What we do know is that screening works. Early intervention is good" (Luthra). Autism screening is not a simple blood-test or cheek-swab. It is close observation of a child by their parents and pediatrician as well as a series of questions for the parents regarding the child's development timeline and meeting of milestones (Autism Speaks). The American Academy of Pediatrics (AAP) recommends developmental screening at every preventative care visit and the use of standardized general screening tests at nine, eighteen, and thirty month visits as well as Autism Spectrum Disorder specific screening tests at eighteen and twenty-four month visits (Lipkin). Pediatricians are the ones who should be mainly concerned with autism and screening for the disorder. Having big pediatric organizations testify for mandating autism screening, such as the American Academy of Pediatrics, which consists of over 60,000 pediatricians, is a plus when trying to make autism screening mandatory. If those who are mainly concerned with and work with autism (pediatricians) argue that screening should be mandatory, that shows how important this issue must be. 

Since autism screening is not mandatory, not all children who are affected by the disorder are accounted for. Without having an actual count of those affected by autism means that data regarding autism rates is inaccurate. One way that the CDC compiles it figures is through the Autism and Developmental Disabilities monitoring Network, that tracks children in eleven different communities around the United States (Hamilton). Researchers make lists of which children have autism in each community by reviewing records from schools, doctors, social services agencies and other places that work with developmental disorders (Hamilton). This method can miss a lot of children who have autism because if the child is not receiving services, they are not documented and accounted for. Enormously staggering autism rates among communities are signs of issues regarding this approach. For example, figures from a New Jersey community indicate that one in forty-five children have autism spectrum disorder, while figures in Alabama project that one in 175 children are affected (CDC). When looking at these numbers, one may conclude that simply more children in New Jersey suffer from autism than children in Alabama. As autism is still a mystery as to why and how it occurs, a better explanation would blame undocumented cases. In some communities, children are less likely to be diagnosed or use services than in other communities (CDC). Without autism screening being mandatory, children can still go to physicians but not be diagnosed because they were never screened. There are also children who do not have access to proper primary care, thus never getting screened for autism. In both of these situations, there are likely to be children who indeed suffer from autism but are not accounted for. With these children not being correctly documented and accounted for, data regarding autism rates in certain areas in inaccurate and may be skewed. Autism Spectrum Disorder is such a prevalent disability in our country (one in sixty-eight children are affected) so having accurate data regarding it and its affection rate is necessary. Autism does not have any type of medical way of diagnosis or cure, so research on the disorder is common today (Autism Speaks). Research relies heavily on data and having inaccurate data hinders the full potential of research as well as creates multiple setbacks. With children affected by autism being undocumented for because they were never screened, both the individual child and researchers suffer. Autism screening is not mandatory, therefore those with healthcare may not be screened and those without healthcare are not provided access to screening because it is not seen as essential for all children. If screening was made mandatory, all of those with healthcare would be screened and those without healthcare would be provided access to screening. Then, data would be made more accurate because more of those affected would be diagnosed and documented for, increasing the credibility of the data.

Screening for autism does not incur a medical procedure. Currently, there is no medical way to detect autism: blood-draws and cheek-swabs cannot diagnose the disorder (Autism Speaks). Diagnosis relies solely on observed and reported behavior of the child in question. Unfortunately, most of the symptoms of autism are similar to those of a troubled, difficult or disobedient child. Symptoms include poor or inappropriate social interaction, poor eye contact, impulsivity, repetitive actions, speech and communication problems, anxiety and attention problems (Autism Speaks). These qualities can also be recognized as simply a troubled child or a slow learner. With screening for autism not being mandatory, a parent may never screen their child for autism or ever be introduced and familiarized with the disorder. Without knowing what autism is and what symptoms to look for, it would be easy for a child with autism to be brushed off as simply a difficult kid. A difficult child should not be treated the same as an autistic child. There are ways to differentiate between autism and naughtiness in a child, but without proper knowledge of autism and prior screening, these differences are not recognized and thus can leave a child suffering from autism while being treated as a bad kid. Parents are more likely to be familiar with the signs of a tempered child than those of an autistic one and would most likely put their child in that category. This is not fair to children with autism because I have learned first-hand that any child with special needs is going to need treatment and accommodations before they can start to behave better or relieve some of their symptoms. Yelling at an autistic child and constantly telling them to stop does not register correctly in their brain and they will not benefit or act better due to these actions. Each autistic child is different and has a different level of severity of their disorder. If all children had to be screened for autism, then more children will be correctly diagnosed and treated for their specific level of the disorder. More parents will be knowledgeable about the disorder, even if their child is not autistic, so autism will be more universally known and recognized. 

Though many benefits would come from mandatory autism screening, there are opposing ideas and testimonies. The major opponent to the making of mandatory autism screening is the government. The government health panel that makes recommendations on preventative care, the U.S. Preventative Task Force, claims that more studies are needed to determine whether all children under the age of three would benefit over the long term if they were screened, even if they showed no symptoms (Leonard). Dr. David Grossman, vice chairman of this task force explains that, "we are not telling doctors to stop screening, but we also aren't telling them they should all be screening ...  what this is more than anything is a call for research" (Leonard). While it is stated by screening supporters that autism testing is non-invasive, Grossman argues that though this may be true, every test has false positives and false negatives (Leonard). Though false-positive screening tests create stress, anxiety and an increased expense of additional evaluation, many times other developmental disorders are discovered instead of Autism Spectrum Disorder, which otherwise would not have been detected (Lipkin). Grossman argues that doctors should consider their own patients and decide whether or not to screen for autism, based primarily off parent's request (Luthra). This does make sense for the most part as essentially parents decide what is best for their child. What if the parents of a child are not educated and do not ask for screening simply because they are not aware of or offered it? Jeremy Veenstra-VanderWeele, a professor of psychiatry at Columbia University, raises such a situation. "The family with a lot of resources that has a strong educational background is going to raise concerns earlier and is going to push for a referral, whereas the family without those resources wont necessarily push, or be in a position to push in the same way" (Veenstra-VanderWeele). Grossman's approach is partial to those who are educated and have funds, which can leave others who suffer from autism without these benefits in the dark. Opponents of mandatory autism screening believe that screening could impose burdens on the primary care physician (Lipkin). It may incur an unwanted extra amount of time at the doctor's office for a simple preventative care visit as well as waste a doctor's time on screening a child showing no symptoms of autism. A study created by Alison Schonwald and other pediatricians was conducted to examine the effectiveness of developmental screening of children. Researches implemented mandatory autism screening to all patients attending well-child care visits between six months and eight years of age in two separate pediatrician's offices. Outcomes were evaluated by comparing the length of visit times and amount of referrals for developmental concerns before and after implementation of screening. It was found that having autism screening become routine for each and every child was easier and more time-effective than only offering it when asked (Schonwald). Thus, perceived obstacles, such as the time requirement of screening, should not prevent widespread adoption of screening (Schonwald). No significant about of time was added on to the visits and making screening a practice-wide routine was time-efficient and kept screening as simple and easy as possible. 

Autism screening being made mandatory is a plausible and legitimate argument. Autism is a problem in our world today and screening is the only means of diagnosis. Children are not being properly diagnosed and seen as simply a troubled child because they were never screened for autism. It has been researched and found that adding routine autism screening to child well-care visits is beneficial in reporting and discovering more cases of autism while not adding an immense amount of time with the doctor (Schonwald). If autism screening was mandatory, those children who are without healthcare would most likely be given access to some kind of means of screening, ensuring that all children are screened. This could eliminate the problem of data inaccuracy regarding autism rates, which is important to researchers of the autism spectrum disorder. Less children will go a long time, or even a lifetime, without knowing that they suffer from autism. Those who have autism need special accommodations, and those who suffer from the disorder but are never screened are deprived of these necessary services. A child suffering from autism that is treated as a child who does not suffer from autism is unfair and will likely live a lower quality of life than they should. Children being left in the dark because they were never screened for autism is the problem and putting mandatory autism screening for all children in place is the solution. Many organizations, such as Autism Speaks and the American Academy of Physicians, are encouraging that autism screening be made mandatory. Government panelists are disagreeing and saying that more research is to call for regarding the subject because of potential wasted time and money (Leonard). By educating people on autism and the problems surrounding it, awareness could increase and there could be a bigger and stronger argument advocating for mandatory autism screening, possibly changing the government panelist's minds. My argument has an exact place where change can be made, and it occurs in the doctor's office. Making autism screening mandatory and a routine process for those administering well-child care visits could decrease the amount of children who go undiagnosed and increase awareness of the disorder. We can effect this change by further increasing public knowledge of autism and possibly spark a bigger fire that justifies mandatory autism screening and gets more attention. This is not a bigger current issue simply because of lack of knowledge. I have worked with children with autism for years and did not know how extremely widespread this disorder is until doing research. By getting people more informed and involved, I believe that there will be a bigger and better argument for the mandating of autism screening. It is easy to see how autism is something that only effects those who suffer from it or are around it. So why should we care? If one does not have autism in their lives somehow, why should this be a big deal to them? Knowledge and growth is the reason why it should be a big deal to all. Autism is still a mystery in many ways as researchers are trying to figure out what exactly causes it and if there could be a cure. So many are affected by autism and the numbers are growing rapidly (Autism Speaks). With this being such a prevalent disorder, it would be beneficial in many ways to know as much about the disorder as possible. The same idea can be applied to cancer. Cancer is also a widespread disease and there still is a lot we do not know about it and have yet to find a cure. Cancer research has been so advanced because of awareness. If people were more aware and knowledgeable about autism, research would most likely advance. So why should we care? Diseases like autism have to be perceived as "the big picture." A large majority of people are suffering from autism and without public knowledge of the disorder and how popular it is, research regarding autism will not succeed because it will not be seen as necessary. The more people who are aware of autism and what it is and how mandatory autism screening can be beneficial, the more likely that it will be further addressed as the pressing problem that it is. Thus, there will be a bigger push to produce a solution for those suffering with autism but are unaware: mandatory autism screening.

Autism is a wide-spread disorder that influences the lives of many, affecting one in sixty-eight children (Autism Speaks). Though this number is astonishing, it may not be completely accurate and the actual rate is even higher. Autism screening is not mandatory, therefore not every child is screened for the disorder. Children with healthcare may not be screened and children without healthcare are not given access to screening because it is not mandatory. In both scenarios, children who suffer from autism may never be screened and diagnosed and could go far into their life without knowing they have the disorder. Undiagnosed children who suffer from autism are not given the proper treatment and accommodations they need to succeed, such as separate setting schooling, therapy, tutoring, assisted living and enhanced teacher-parent association (Autism Speaks). If screening was made mandatory, it would be possible for all children with autism to be correctly diagnosed in a timely manner and receive the care and treatment that they need. Mandatory screening would offer early diagnosis and treatment, which is proven to lessen the effects of autism (Lipkin).  By putting mandatory autism screening in place, less children who suffer from autism will go untreated and undocumented for, benefiting both the individual and the data surrounding autism spectrum disorder.

