Autism risk can be detected during 1st-birthday screening

A quick test at a child's 1-year well-baby checkup can detect autism spectrum disorder (ASD), enabling pediatricians to clinically identify children at risk and refer them for early treatment, according to a recent study.

A network of 137 pediatricians in San Diego County, California, agreed to screen without exclusions all infants seen in their offices for the 1-year well-baby checkup with the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, a 24-item parent-report questionnaire that quantifies an infant's social and emotional communication, receptive and expressive speech, and symbolic behavior.

The study called for parents to fill out the checklist, which was immediately scored by medical staff, in the waiting room. The pediatrician reviewed the screen scores before the examination and referred any patient who failed for further evaluation. Copies of the completed forms were collected every 2 weeks.

Infants were considered at risk for ASD based on failure on the Autism Diagnostic Observation Schedule-Toddler Module, the Mullen Scales of Early Learning, and clinical judgment any time between 12 and 18 months; provisionally ASD between 19 and 31 months; and confirmed as ASD between 32 and 36 months with the Autism Diagnostic Interview-R.

Thirty-two infants received provisional or final diagnosis of ASD.

Researchers say their study confirms the feasibility of using a broad screen to detect ASD in children as young as 12 months with relatively little effort or cost on the part of clinicians.

Pierce K, Carter C, Weinfeld M, et al. Detecting, studying, and treating autism early: the one-year well-baby check-up approach. J Pediatr. 2011. Epub ahead of print.