Study uses checklist to screen for early autism warning signs

A SIMPLE checklist that parents fill out in the waiting room may help doctors to some day screen for warning signs of autism as early as a baby’s first birthday.

San Diego paediatricians tested the tool with more than 10,000 babies at their one-year checkups, looking for such things as how the children babble, gesture and interact with others.

The research is a first step in the quest for earlier autism screening. It is not ready for routine use, as more work is needed to verify its accuracy. But it also may prove valuable in finding more at-risk babies to study what causes the developmental disorder.

“There are subtle signs of autism at one year if you just look for them,” said neuroscientist Karen Pierce of the University of California, San Diego, who led the study. “Let’s just get these kids detected early and treated early.”

Autism ranges from mild to severe problems with behaviour, communication and socialisation. The American Academy of Paediatrics already urges autism screening during regular doctor visits at 18 months and 24 months. Yet a 2009 study found that on average, children are not diagnosed until they are 5.

Experts say early therapy can lessen autism’s severity, even if they do not know exactly what types will prove best.

“The earlier you start, the better,” said Dr Lisa Gilotty of the US National Institute of Mental Health, which helped fund the study.

Hence the interest in younger screening.

“This is very exciting work, to think we may be able to identify children with autism this early,” said Dr Susan Hyman of the University of Rochester and a paediatrics academy autism specialist, who wasn’t involved in the study.

But, she cautioned, it’s not clear how best to do that.

“I don’t think screening for autism at 12 months is ready for prime time.”

The study uses a 24-question checklist written in easy-to-understand terms that parents can answer in about five minutes. It was developed a few years ago to detect broader signs of language or developmental delays. Ms Pierce signed up 137 paediatricians to use the questionnaire during every one-year checkup and refer babies who failed for further testing. Those youngsters were re-evaluated every six months to age 3, when a diagnosis could be certain.

Of 10,479 babies screened, 184 who were sent for further testing followed through — and 32 eventually were diagnosed with autism, Ms Pierce reported in the Journal of Paediatrics.


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