Simple Well-Baby Checklist Can Identify Children with Autism at First Birthday
Researchers with the University of California San Diego have developed a simple checklist that can be administered at the one-year well-baby checkup that has the potential to identify children early who have autism spectrum disorders (ASD). Early detection and treatment can have a positive impact on the developing brain, notes lead author Karen Pierce PhD, a professor of neuroscience.
Checklist Has 75% Accuracy for Identifying Language or Develomental Delays
The American Academy of Pediatrics (AAP) recommends that all children be formally screened for autism at their 18- and 24-month checkups, whether or not they have symptoms. However, the opportunity to diagnose and begin treatment even earlier – at or around the child’s first birthday – has “enormous potential to change outcomes,” says Dr. Pierce.
Pierce and colleagues conducted a pilot study of the 24-item questionnaire among more than 10,000 babies at the offices of 137 San Diego County pediatricians. The checklist can be filled out by parents or caregivers in five minutes while they wait for their one-year well-baby checkup.
Called the “Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-IT)”, the questionnaire covers three areas: social and emotional communication, receptive and expressive speech, and symbolic behavior. It rates a child’s use of eye contact, sounds, words, gestures, object recognition and other forms of communication as compared with age-appropriate norms.
The benefits include that it can be administered at “virtually no cost”, requiring less than two minutes worth of time to score by medical staff. Pediatricians interviewed by Dr. Pierce said that the tool increased their awareness of autism and its earliest signs. 96% said that it was a tool they would be likely to use in their own offices.
Unfortunately, though, the checklist had a relatively high false-positive rate which could cause anxiety for parents. Of the 184 infants that were positively screened for problems in the pilot study and referred to the University’s Autism Center of Excellence for further testing and re-evaluation, 32 ultimately received a provisional or final diagnosis of ASD and 46 were false positives. The remaining children were diagnosed with language delays, developmental delays or “other deficits” and began treatment between 17 and 19 months, on average.
Pierce K, et al "Detecting, studying, and treating autism early: The one-year well-baby check-up approach" J Pediatr 2001; DOI:10.1016/j.jpeds.2011.02.036.