The Society of Diagnostic Medical Sonography (SDMS) is concerned that a recent article, Severity of ASD Symptoms and their Correlation with the Presence of Copy Number Variations and Exposure to First Trimester Ultrasound, published by the International Society for Autism Research in Autism Research, may cause pregnant women who have been referred for a medical ultrasound (sonogram) to skip or delay a medically necessary examination. 

Sheryl Goss, MS, RT(R)(S), RDMS, RDCS, RVT, FSDMS, the President of the SDMS stated, “Based on all of the available research and the millions of sonographic examinations performed each year, the SDMS believes that sonography examinations are safe and beneficial, when performed for a medical purpose and by a person with appropriate education, training, experience, and certification. We encourage pregnant women to talk with their physician if they have questions or concerns. However, they should NOT avoid having medically necessary examinations using ultrasound during pregnancy based on this limited study.”

Sonography involves the use of high-frequency sound waves (ultrasound) to generate medical images and is the most common medical imaging examination performed during pregnancy. The article suggests a mathematical link between having a diagnostic ultrasound in the first trimester of pregnancy and an increase in severity of some autism symptoms in the autistic child. However, most ultrasounds are not completed during the first trimester of pregnancy, which is the only trimester studied and reported in Autism Research. Additionally, while the SDMS, American Institute of Ultrasound in Medicine (AIUM), American ​College of Obstetricians and Gynecologists (ACOG), and Food and Drug Administration (FDA) share the article’s concern over the proliferation of the non-medical use of ultrasound for “entertainment” purposes, deficiencies in the study’s research design raise serious questions about the conclusions drawn by the study’s authors.

According to Kevin Evans, PhD, RT(R)(M)(BD), RDMS, RVS, FSDMS the Professor and Division Chair at The Ohio State University School of Health and Rehabilitation Sciences’ Radiologic Sciences and Therapy Division and the incoming Editor for the Journal of Diagnostic Medical Sonography (JDMS), this type of research is very difficult to conduct and the study’s design is limited by threats to internal and external validity. “These factors are compounded because of a lack of randomization of the subjects and the semi-structured interview process used in this study. To truly control for extraneous variables, the research would require a pre-clinical study that was randomized and highly controlled” Dr. Evans said.

Dr. Evans concluded, “I do not think this study and article are strong enough to make the assertions found in the discussion and certainly cannot support the statements made in the article’s abstract. More properly designed research is needed to prove or disprove any link between ultrasound and autism.”

Ms. Goss added, “Patients, physicians, and the study’s researchers should be concerned if unqualified personnel are performing these examinations because they may be unaware of the techniques used by certified sonographers to limit exposure to ultrasound during every patient examination.” Currently only four states (Oregon, New Hampshire, New Mexico, North Dakota) have passed legislation to require certification and licensure of diagnostic medical sonographers. Ms. Goss recommends that before scheduling a sonography examination ordered by their physician, patients should ask if the sonographer is certified to perform obstetrical sonography by the American Registry for Diagnostic Medical Sonography (ARDMS) or the American Registry for Radiologic Technologists (ARRT).

Additional Resources: 
AIUM ​Responds to Autism Study
Let's Take a Look at that Autism-Ultrasound Link - Forbes.com