Quicker Way to Know Sooner

5-minute autism spectrum disorder screening for infants

(RxWiki News) A mom sits in her pediatrician's office and fills out a checklist about her baby. Someday, just such a simple screening may be available to diagnose autism spectrum disorder (ASD) in infants.

According to a new study, a five-minute checklist that parents can fill out in pediatrician waiting rooms may someday help in the early diagnosis of ASD. The study also included a method to help pediatricians begin using this type of autism screening.

"Beyond this exciting proof of concept, such a screening program would answer parents' concerns about their child's possible autism symptoms earlier and with more confidence than has ever been done before," said Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), part of National Institutes of Health (NIH), which funded the study.

"Checklist for diagnosing autism in infants shows promise."

It's well known that identifying autism at an early age allows children to start treatment sooner, which can have a tremendous impact on their development and learning in later years. However, diagnosing autism usually takes years, with long delays between the time parents first report concerns about their child's behavior and the eventual diagnosis.

A 2009 study using Centers for Disease Control and Prevention (CDC) data found that children typically receive an ASD diagnosis at around 5.7 years, with treatment beginning sometime later.

Karen Pierce, Ph.D., of the University of California, San Diego, and colleagues designed the new study as a means for helping parents and pediatricians screen infants at their one-year wellness check-up.

The study used the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist. This brief questionnaire identifies autism, language and developmental delays. It asks caregivers about the child's:

  • Eye gaze and focus - if he or she makes eye contact with someone who is talking with them
  • Use of sounds, words, gestures and objects
  • Other forms of communication that's typical for infants

The brief screen proved to be accurate 75 percent of the time when it was used to identify both ASD and language, developmental and other delays.

Following the screen, all toddlers diagnosed with ASD or developmental delay and 89 percent of those with language delay were referred for behavioral therapy. On average, these children were referred for treatment around age 17 months.

In addition to tracking infant outcomes, the researchers also surveyed the participating pediatricians. Prior to the study, few of the doctors had been screening infants ASD. After the study, 96 percent of the pediatricians rated the program positively, and 100 percent of the practices have continued using the screening tool.

"In the context of a virtual lack of universal screening at 12 months, this program is one that could be adopted by any pediatric office, at virtually no cost, and can aid in the identification of children with true developmental delays," said Dr. Pierce.

The researchers say that future studies should look to further refine and validate this screening tool; track children until a much older age and assess barriers to treatment follow-up.

The Study

  • 137 pediatricians in San Diego participated
  • 10,478 infants screened
  • Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist used
  • Caregivers asked about how child used all forms of age-appropriate communication
  • Of total infants screened, 32 were identified as having ASD
  • After excluding for late onset and regression cases, this is consistent with current rates that would be expected at 12 months
  • All toddlers diagnosed with ASD and most with other development delays were referred for behavioral therapy
  • Most children referred for treatment at around age 17 months
Review Date: 
May 9, 2011