Date Published: 28 April 2011

5-min checklist - Autism in 1 year olds

Health News from the United States of America (USA)

Autism is not always diagnosed at an early age.
What is an early age for the diagnosis of autism ?

A recent study funded by the US-based National Institutes of Health (NIH) has demonstrated the feasibility and effectiveness of conducting systematic screening for autism during the usual well-baby check-ups. According to the NIH a simple "five-minute checklist" that parents can complete in pediatrician waiting rooms may assist with the early diagnosis of autism spectrum disorders (ASD)s in the future. Details of the recent study have just been published*.

" Beyond this exciting proof of concept, such a screening program would answer parents' concerns about their child's possible ASD 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), which is part of NIH.

Identifying autism at an early age allows children to receive treatment sooner, thereby significantly improving their potential success with development and learning-related activities. Unfortunately many studies indicate that there is often a significant delay between the time parents first report concerns about their child's behavior and the eventual ASD diagnosis, resulting in some children not receiving a diagnosis or relevant assistance until long after they have entered full-time education.

General information about the recent study re. early diagnosis of autism

Dr Karen Pierce of the University of California, San Diego, and her colleagues established a network of 137 pediatricians across San Diego County. Following an hour-long educational seminar, the pediatricians screened all infants at their 1-year, well-baby check-up using the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, a brief questionnaire that detects ASD, language delay, and developmental delay. The questionnaire asks caregivers about a child's use of eye gaze, sounds, words, gestures, objects and other forms of age-appropriate communication. Any child who failed the screen was referred for further testing and was re-evaluated every six months until age 3.

Of 10,479 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. When including those identified as having language delay, developmental delay, or some other form of delay, the brief screen provided an accurate diagnosis about 75% of the time.

Following the screen, all toddlers diagnosed with ASD or developmental delay and 89% of those with language delay were referred for behavioral therapy. On average, these children were referred for treatment around age 17 months. This may be compared with data from a 2009 study using information from the Centers for Disease Control and Prevention which found that, on average, children currently receive an ASD diagnosis around 5.7 years (68.4 months) of age, with treatment beginning sometime later.

Researchers involved in the recent study also surveyed the participating pediatricians. Prior to the study, few of the doctors had been screening infants systematically for ASD. After the study, 96%t of the pediatricians rated the program positively, and 100% 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.


Reference to Paper*:
Pierce K, Carter C, Weinfeld M, Desmond J, Hazin R, Bjork R, Gallagher N. Catching, Studying, and Treating Autism Early: The 1-Yr Well-Baby Check-Up Approach. J Pediatr. 2011 Apr.

About NIH:
The National Institutes of Health (NIH) ? The Nation's Medical Research Agency ? includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit - statement understood to be correct as of publication date.

Source: National Institutes of Health (NIH), USA.

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