Autism screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Screening

About half of parents of children with ASD notice their child's unusual behaviors by age 18 months, and about four-fifths notice by age 24 months. As postponing treatment may affect long-term outcome, any of the following signs is reason to have a child evaluated by a specialist without delay:

  • No babbling by 12 months.
  • No gesturing (pointing, waving goodbye, etc.) by 12 months.
  • No single words by 16 months.
  • No two-word spontaneous phrases (not including echolalia) by 24 months.
  • Any loss of any language or social skills, at any age.

The American Academy of Pediatrics recommends that all children be screened for ASD at the 18- and 24-month well-child doctor visits, using autism-specific formal screening tests.[1] In contrast, the UK National Screening Committee recommends against screening for ASD in the general population, because screening tools have not been fully validated and interventions lack sufficient evidence for effectiveness.[2] Screening tools include the Modified Checklist for Autism in Toddlers (M-CHAT), the Early Screening of Autistic Traits Questionnaire, and the First Year Inventory; initial data on M-CHAT and its predecessor CHAT on children aged 18–30 months suggests that it is best used in a clinical setting and that it has low sensitivity (many false-negatives) but good specificity (few false-positives). Screening tools designed for one culture's norms for behaviors like eye contact may be inappropriate for a different culture.[3] Genetic screening for autism is generally still impractical.

References

  1. Johnson CP, Myers SM, Council on Children with Disabilities (2007). "Identification and evaluation of children with autism spectrum disorders". Pediatrics. 120 (5): 1183–215. doi:10.1542/peds.2007-2361. PMID 17967920. Lay summaryAAP (2007-10-29).
  2. Williams J, Brayne C (2006). "Screening for autism spectrum disorders: what is the evidence?". Autism. 10 (1): 11–35. doi:10.1177/1362361306057876. PMID 16522708.
  3. Wallis KE, Pinto-Martin J (2008). "The challenge of screening for autism spectrum disorder in a culturally diverse society". Acta Paediatr. 97 (5): 539–40. doi:10.1111/j.1651-2227.2008.00720.x. PMID 18373717.

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