Detecting, Studying, and Treating Autism Early: The One-Year Well-Baby Check-Up Approach

Published September 1, 2011 in Journal of Pediatrics

A five-minute checklist filled out by parents at the one-year, well-baby check-up has been shown to predict autism or other developmental delays in about 75 percent of cases. This easily implemented tool is the first validated autism screen for infants and could help pediatricians identify autism even earlier than the evaluations at 18 and 24 months of age recommended by the American Academy of Pediatrics. The screening tool, called the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, developed by Dr. Amy Wetherby and colleagues, was filled out by parents in the waiting room and took pediatricians only two minutes to review, providing a quick way to identify young children at risk for ASD. The study followed 137 pediatricians in San Diego County who used the tool to screen almost 10,500 infants. About 12 percent of infants screened were flagged by the questionnaire as at-risk for ASD and referred for further evaluation at a clinic. The study followed 184 infants who failed the screen until three years of age and found that 17 percent (32 children) ultimately received an autism diagnosis. Of the remaining children, 30 percent were identified as having a learning disability, 5 percent with a developmental disability, and 20 percent as another type of disability. Overall, the screen yielded about a 30 percent false-positive rate, meaning that 1 out of 3 infants flagged as at-risk during the initial screen did not subsequently receive a developmental disorder diagnosis. The findings demonstrate that the checklist is a convenient and effective screen for autism and other disabilities at the one-year, well-baby check-up – improving the chances of early detection and increasing the opportunity for early intervention. Notably, all 137 pediatricians who participated in the study were still using the checklist when the article was published — a significant improvement from the only 22 percent who were screening at one-year check-ups prior to the study.

–IACC 2011 Summary of Advances in ASD Research

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