A study scheduled to be published in The Journal of Pediatrics evaluated the ability of a simple questionnaire to predict autism at the 1 year check-up (download survey for free here). The survey, which is only 24 questions long and can be completed in 5 minutes, evaluated 10,500 children and flagged 184 as potentially at-risk. The researchers followed up with those children every 6 months for 3 years and found that 32 of the 184 infants were diagnosed with autism spectrum disorders, 56 with language delays, 9 with developmental delays, and 36 with "other" delays.
However the screening is far from perfect. For one, the study under-reported the number of children diagnosed with both developmental delay and autism. There is a currently accepted rate of 1 in 6 children diagnosed with developmental delay in the US, with 1 in 127 children being diagnosed as autistic. 25% of the children who failed the test ended up developing normally, which left the developmental delay rate at 1 in 79 and the autistic rate at 1 in 329. Also, because these babies were evaluated at 1 year and 25% of ASD diagnoses happen after a child's 1st birthday, there's no way for this study to pick up these children.
There's one more important point related to this, though. If the parents are bringing their babies in for the annual check-up, then there's a really high chance that the infant is about to get with 8 vaccinations on that visit. If the parents have followed the AAP's recommendations, that will be on top of the 14 they've already had earlier in the year. So one possible reason the screening missed so many children is that they're developing completely normally, right up until this visit.
Early detection seems to be really helpful in helping children with developmental delay, and any reliable screening tool that can pick up a problem is worth our time. However, its important for parents and health care providers to keep the results of this survey in the context of the child's overall health picture. Perhaps instead of only using the survey at 1 year, following up at 18 months and 3 years would be a better practice for early detection.
Download Wetherby & Prizant's CSBS DP Infant-Toddler Checklist here
Download instructions here (scoring instructions on page 3)
Roan, S. (2011). "Autism screening test could be offered to 1-year-olds." Los Angeles Times, published online Apr 28, 2011.
Update: The abstract has been published online:
Karen Pierce, Cindy Carter, Melanie Weinfeld, Jamie Desmond, Roxana Hazin, Robert Bjork, Nicole Gallagher (2011). "Detecting, Studying, and Treating Autism Early: The One-Year Well-Baby Check-Up Approach." The Journal of Pediatrics. Published ahead of print April 29, 2011.
