Autism spectrum disorder: Screening tools
- Carolyn Bridgemohan, MD
Carolyn Bridgemohan, MD
- Section Editor — Developmental and Behavioral Pediatrics
- Assistant Professor of Pediatrics
- Harvard Medical School
Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains: 1) deficits in social communication and social interaction and 2) restricted repetitive patterns of behavior, interests, and activities . ASD encompasses disorders previously known as autistic disorder (classic autism, sometimes called early infantile autism, childhood autism, or Kanner's autism), childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified, and Asperger disorder (also known as Asperger syndrome). (See "Autism spectrum disorder: Diagnosis", section on 'Diagnostic criteria' and "Asperger syndrome (a specific autism spectrum disorder): Clinical features and diagnosis in children and adolescents" and "Asperger syndrome (a specific autism spectrum disorder): Management and prognosis in children and adolescents".)
Screening tools for ASD will be reviewed here. The rationale for screening and management of children who have a positive screening test and the epidemiology, pathogenesis, clinical features, diagnosis, and management of ASD are discussed separately.
(See "Autism spectrum disorder: Surveillance and screening in primary care" and "Autism spectrum disorder: Terminology, epidemiology, and pathogenesis" and "Autism spectrum disorder: Clinical features" and "Autism spectrum disorder: Diagnosis" and "Asperger syndrome (a specific autism spectrum disorder): Clinical features and diagnosis in children and adolescents" and "Autism spectrum disorder in children and adolescents: Overview of management".)
Screening is defined as a brief, formal, standardized evaluation used to identify unsuspected deviations from normal patterns of development. A screening instrument enables detection of conditions/concerns that may not be readily apparent without screening. Screening does not provide a diagnosis; it helps to determine whether additional investigation (eg, a diagnostic evaluation) by clinicians with special expertise in developmental pediatrics is necessary . Effective screening requires that results from standardized screening tests be considered in conjunction with clinical judgment. Desirable characteristics of developmental and behavioral screening tests are discussed separately. (See "Developmental and behavioral screening tests in primary care", section on 'Screening tests'.)
Indications — Screening for ASD is indicated in children with delayed language/communication milestones, in children with a regression in social or language skills, and in children whose parents raise concerns regarding ASD. In addition, the American Academy of Pediatrics recommends ASD-specific screening of all children at 18 and 24 months of age because these are critical times for early social and language development, and earlier intervention is more effective for ASD . (See "Autism spectrum disorder: Surveillance and screening in primary care", section on 'Guidelines for surveillance and screening' and "Autism spectrum disorder: Surveillance and screening in primary care", section on 'Early intervention'.)
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- Tiered screening model
- Important caveats
- TOOLS FOR CHILDREN <3 YEARS
- Checklist for Autism in Toddlers
- Modified CHAT, Revised with follow-up
- Screening Tool for Autism in Two-Year-Olds
- Infant-Toddler Checklist
- Parent's Observations of Social Interactions
- TOOLS FOR PRESCHOOL AND SCHOOL-AGE CHILDREN
- Social Communication Questionnaire
- Childhood Autism Syndrome Test
- Autism Spectrum Screening Questionnaire
- Autism-Spectrum Quotient
- - AQ-Child
- TOOLS FOR CHILDREN WITH INTELLECTUAL DISABILITIES
- Developmental Behaviour Checklist - Autism Screening Algorithm
- Developmental Behaviour Checklist - Early Screen
- COMPARISON STUDIES
- CHOICE OF SCREENING TEST
- INFORMATION FOR PATIENTS