WebMD Medical News
Laura J. Martin, MD
April 28, 2011 -- A simple checklist completed by parents can help doctors screen for signs of autism as early as the child’s first birthday, according to new research.
''I am hoping it will become the standard of care," researcher Karen Pierce, PhD, an assistant professor of neuroscience at the University of San Diego School of Medicine, tells WebMD.
She recently tested the screen, asking 137 pediatricians throughout San Diego County to take part. At the 12-month well baby visit, the doctors asked the parents to answer the 24-item checklist. The questions ask about their child's emotions, eye gaze, communication, gestures, and other behaviors.
The screen found suspected autism, autism spectrum disorder, language delays, or other developmental problems about 75% of the time, Pierce says.
"One of every four times, it will be wrong," she says. "The price to pay for that is actually very tiny" compared to the benefit of early intervention.
Currently, 5.7 years is the median age (half older, half younger) at which children receive an autism diagnosis, according to a 2009 study.
About one in 110 children in the U.S. has autism or autism spectrum disorder, a group of developmental disabilities that cause social, behavioral, and communication challenges.
The new study is published online in the Journal of Pediatrics.
The screen used is already published and is available online for free download. It is called the CSBS DP IT checklist (Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler).
The questionnaire takes about five minutes to complete, Pierce says.
Among the questions:
"This is not an autism-specific screen," Pierce tells WebMD. "It's a screen to catch autism and other developmental delays."
The doctors screened 10,479 infants. Of them, 1,318 children failed. Pierce evaluated 184 of the children who failed the screen and were evaluated for autism, autism spectrum disorder, language delays, or other developmental delays. The researchers also tracked 41 of the 9,161 children who passed the checklist, who served as a comparison group.
To date, 32 of the children got a final or provisional diagnosis of autism or autism spectrum disorder, which encompasses a wider spectrum of developmental problems. Another 46 received a false-positive diagnosis of autism, uncovered with evaluation.
Five babies who tested positive for ASD later no longer met the criteria. Fifty-six were diagnosed with learning disabilities, nine with developmental problems, and 36 with "other" developmental problems.
It is critical, Pierce says, that a doctor who uses the screen has access to a center where he can refer patients for more evaluation.
In 2007, the American Academy of Pediatrics issued a report introducing universal screening for autism at ages 18 months and 24 months.
The new finding is an important step forward, says Geraldine Dawson, PhD. She is the chief science officer for Autism Speaks. Autism Speaks supported the study as did the Organization for Autism Research and the National Institute of Mental Health.
"We do know that many babies who go on to develop autism begin to show symptoms early on," she says.
It may be half or more of all children with autism, she says.
''For babies who have this pattern of early onset, to use a screen that is quick and can be used in a pediatrician's office efficiently is of great value," she says. The earlier autism is detected, the earlier intervention can begin.
SOURCES:Karen Pierce, PhD, assistant professor of neuroscience, University of California San Diego School of Medicine and Autism Center of Excellence.Geraldine Dawson, PhD, chief science officer, Autism Speaks.Pierce, K. The Journal of Pediatrics, published online April 28. 2011.Shattuck, P. Journal of the American Academy of Child and Adolescent Psychiatry, May 2009; vol 48: pp 474-483.
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