Autism screening

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

Overview

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.[1] 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.[2]

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.[3] 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.[4] 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).[1] Screening tools designed for one culture's norms for behaviors like eye contact may be inappropriate for a different culture.[5] Genetic screening for autism is generally still impractical.[6]

References

  1. 1.0 1.1
  2. 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).
  3. 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.
  4. 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.