A checklist given to parents to fill out in pediatrician waiting rooms may help early detection of autism spectrum disorder (ASD), according to a study published in the Journal of Pediatrics.
Funded by the National Institutes of Health (NIH), the five-minute questionnaire identifies children with autism at an early age to allow them to start treatment sooner, which can greatly improve their development and learning.
“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,” notes Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), part of NIH.
The study also found that a significant delay exists between the time parents first report concerns about their child’s behavior and the ASD diagnosis. Some children do not actually receive a diagnosis until they’re well into starting school.
“There is extensive evidence that early therapy can have a positive impact on the developing brain,” says Karen Pierce, PhD, assistant professor in the UC San Diego Department of Neurosciences. “The opportunity to diagnose and thus begin treatment for autism around a child’s first birthday has enormous potential to change outcomes for children affected with the disorder.”
Researchers at the UC San Diego Autism Center of Excellence (ACE), led by Dr. Pierce, gathered together 137 pediatricians in the San Diego area to help initiate a systematic screen program for all infants at their one-year checkup.
More than 10,000 one-year-old infants were screened with the new approach. Parents were given a brief questionnaire called the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, which asked questions about a child’s use of eye contact, sounds, words, gestures, object recognition and other forms of age-appropriate communication.
Out of these infants, the study found that 184 of them failed the initial screening and were referred to the ACE for further testing and re-evaluation every six months until they turned 3-years old.
So far out of the 184, the study has reported that 32 children have received a provisional or final diagnosis of ASD, 56 children with language delay, 9 with development delay and 36 children diagnosed with “other.” By using the simple five-minute screening technique, an accurate diagnosis was given 75% of the time.
The screening allowed toddlers with ASD or developmental delay, as well as 89% of those with language delay, to be referred for behavioral therapy by an average age of 19 months, says the study.
In comparison, the average age of ASD diagnosis found in a study conducted by the Center for Disease Control and Prevention in a 2009 was around 5.7 years of age, and treatment did not start until sometime later, the press release cited.
In addition to tracking infant outcomes, researchers in the study also surveyed the participating pediatricians.
“When we started giving parents the survey, I found that they listened more carefully to what I had to share with them and paid more attention to their child’s development,” says pediatrician Chrystal E. de Freitas, MD, FAAP, who participated in the study.
“In addition to giving me the opportunity to do a more thorough evaluation, it allowed parents time to process the information that their child might have a development delay or autism ““ a message no parent wants to hear. But, by addressing these concerns early, the child can begin therapy that much sooner.”
After the study, 96% of the pediatricians rated the program positive and 100% of them have continued to use the screening tool, reports the study.
Dr. Pierce points out that “Given lack of universal screening of infants for such disorders at 12 months, this program could be adopted by any pediatric office, at virtually no cost, to aid in the identification of children with developmental delays.”
And she says, “Importantly, parents will be able to get help for their children at a much earlier age than before.”
The researchers say that future studies are needed to further validate and refine the screening tool, track children until a much older age and assess any barriers to treatment follow ups.
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