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As CBS anchor Katie Couric pointed out, autism is not a common condition, afflicting fewer than 0.7% of all children, or one in 150. So it was remarkable that this pediatric story should get such play. Contrast that with the previous pediatric Story of the Day. President George Bush's veto earlier this month of the five-year $35bn extension of the federal subsidy for the S-CHIP children's healthcare plan (text link) led only one newscast, ABC's; NBC did not even consider it worthy of coverage by a correspondent.
The early diagnostic signs of autism had been covered by ABC's Jon Donvan two weeks ago when he introduced us to the autismspeaks.org videostreams that contrast a healthy toddler with a disordered one. Now CBS' in-house physician Jon LaPook and NBC's Tom Costello catch up by including that site in their report on the AAP's guidelines.
All three checked off a cluster of autistic symptoms: failure to respond to one's name, to return a smile, to make eye contact, to point at objects. ABC's Donvan commented: "It sounds simple but these tests are not something doctors are taught in medical school." NBC's Costello noted that "the definition of autism has expanded over the past 20 years" so the number of diagnosis has risen. The object of the universal screening, however, is not to diagnose even more cases, CBS' LaPook explained, but to catch them earlier, since early treatment is more efficacious.
This is all informative enough--as far as it goes. Here are the questions none of the three reporters addressed. Does the AAP agree with the network newscasts that autism screening is a pediatric issue more worthy of coverage than the S-CHIP debate? How does the AAP propose offering universal screening to toddlers when there is no universal healthcare coverage for them? NBC's Costello reported that behavioral treatments for autism take 25 hours each week. How much does that cost? How much extra will the cost be with these earlier diagnoses? Is it covered by insurance? According to the AAP, should it be government funded?
These two pediatric stories are a typical example of the split personality of the networks' healthcare coverage. The S-CHIP story was peppered with interest groups and cost-benefits and trade-offs and power struggles; the autism story enjoys a fantasy of scrupulous care and infinite caution and universal access and cost as no object. The realpolitik approach could be leavened with idealism; and the idealistic approach needs a dose of reality.
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