Monday, 6 June 2011

Quick screening helps spot autism in babies

A brief checklist that parents can fill out while waiting to see their child's paediatrician may aid in diagnosing autismearlier. Early treatment is known to improve outcomes.

Researchers recruited 137 paediatricians in America to give parents of 1-year-olds a 24-question screening test to fill out before seeing the doctor. The test was designed to detect general communication delays, not specifically autism, a neuro-developmental disorder characterised by language and social deficits and repetitive behaviour.

The questionnaire asks about the child's use of eye contact, sounds, words, gestures and other forms of communication. Questions include: Does your child smile or laugh while looking at you? Does your child pretend to play with toys? Do you know when your child is happy? Upset?

Babies who failed the screening were referred for more thorough assessments, including MRIs and a blood test, and were tracked until age 3 years. Of nearly 10,500 babies screened, 184 underwent further evaluation. About 75 percent of these children were found to have autism or another language or development delay.

Currently, paediatricians have no way to screen for autism or other development delays until the child is older. Not only is the test fast and inexpensive, but the children it identified were referred for behaviour therapy at an average age of 17 months, much earlier than children would be otherwise.

However, it was noted that 972 children, about three-quarters of those who failed the waiting room screening, were either not referred for further evaluation or never followed up with additional testing. Possible reasons could be that the test wasn't scored by staff or that paediatricians determined there was no reason for worry and didn't make the referral.

Thirty-two of those were eventually diagnosed with an autism spectrum disorder, 56 with language delay, 9 with developmental delay, 36 with ‘other’ delay and 45 were considered a ‘false positive.’ Five children originally considered to have an autism spectrum disorder no longer met the criteria at follow-up.

The positive sides of the study are that it demonstrates earlier systematic screening for development delays for children at 1 year, is practical and relatively effective. The only concern was that a significant number of families never followed through with testing.

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