Screening for Autism

Approximately 50% of parents of children with autism notice the unusual behavior by the age of 18 months and approximately 80% by age of two years. If a child fails to meet any of the following developmental milestone it is an absolute indication for further evaluation for autism. Any delay in such cases for referral for such testing can have long term effect on the diagnosis, treatment and outcome of such cases.

The following are the milestones which should be met:

  • Babbling by age of one year (12 months)
  • Gesturing such as waving bye-bye, pointing at objects by age of 12 months.
  • Speaking single words by 16 months of age.
  • 2 words spontaneous phrase by age of 2 years (24 months).
  • Loss of any social skill or language at any age.

In many developed countries such as Japan and United States, the common practice is to screen all children at age of 18 months and 24 months. But in some countries such as United Kingdom the practice is to screen the children if their parents or doctors recognize any symptoms of autism.

There are several screening tools available for screening autism in children/toddlers of 18 moths to 24 months such as Modified Checklist for Autism in Toddlers (M-CHAT), the First Year Inventory, and Early Screening of Autistic Traits Questionnaire (ESATQ) etc. Modified Checklist for Autism in Toddlers should be used in clinical setting ant it has low sensitivity and high specificity, which means many false-negatives results and few false positive results.

It should be kept in mind that autism screening tools designed for one culture may not be useful in another culture, e.g. eye contact or hand gesture may mean different in different cultures. Different gesture may mean different in different cultures.



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