Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value?

Researchers studied whether using both autism-specific and general developmental screening tools together is more helpful than using just one type. They tested 408 children at 18 months old and found that using both types of screens together was better at identifying children who might need help, with fewer false alarms. Problems with communication skills were particularly important warning signs. However, no single screening method was good enough on its own at 18 months, so doctors should continue screening children as they grow.

This study examined whether autism-specific and general developmental screening tools provide complementary value when used together at 18-month well-child visits. Researchers followed 408 children, comparing those who failed autism screens (n=167) with matched controls who passed screens (n=241), all receiving diagnostic evaluations. Results showed that combining both screening approaches reduced false positives when considering referrals for autism and/or developmental delay compared to autism-only referrals. Communication subscale failures on developmental screens emerged as important indicators.

While ordinal autism screening showed improved characteristics for detecting autism and/or developmental delay, no screening approach met recommended standards at 18 months, emphasizing the need for ongoing screening as autism symptoms emerge during early development.

Clinicians should use both autism-specific and developmental screens together rather than in isolation. Communication delays warrant particular attention as early warning signs. Multiple screening time points are necessary as single 18-month screening is insufficient. Consider ordinal scoring methods for autism screens to improve detection of developmental concerns.

Sample size not clearly reported. Study type unspecified, limiting assessment of methodological quality. Abstract lacks detail on specific screening tools used, diagnostic criteria, and outcome measurement methods. No information provided about follow-up duration or long-term outcomes.

Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n = 167) and age, gender, and practice-matched children passing screens (n = 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone.

Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development.