Autism Screening: Simple Checklist Could Help Detect Autism Spectrum Disorders in 1-Year-Old Children

April 28, 2011— -- Call it mother's intuition. Linda Powell's only son Samuel was just two months old when she said she knew something was wrong.

"I had a colorful mobile over the changing area and he didn't focus on it at all," Powell said. "Usually by that time they're able to see some colors. I even switched to a mobile with all these different vibrant colors, and he still didn't focus."

That wasn't the only red flag. Samuel made long humming sounds instead of the "da's" and "ga's" of babbling babies his age. And although he liked toys, he didn't play like his curious peers.

Despite the warning signs, it would be three years before Samuel's unusual behavior had a name: Autism.

Current screening methods can signal autism in toddlers 18 months and older. But new research suggests a five-minute survey for parents could detect early signs of autism spectrum disorders in babies by the first birthday. The 25-question survey, which probes babies' verbal communication, emotional expression and gestures, has so far allowed researchers to diagnose autism spectrum disorders correctly 75 percent of the time.

"Up until now, when a mother goes to a doctor and says, 'I think there is something wrong with my child,' the doctor just says, 'Let's wait and see -- some kids are slow in development,'" said Karen Pierce of the autism center at the University of California, San Diego, and lead author of the study published today in the Journal of Pediatrics. "Now you don't have to wait and see anymore. The moment the mother says she is worried about her child's development, the doctor can give her the test and go ahead from there."

Of the nearly 15,000 1-year-olds studied by Pierce and colleagues, 184 failed the screen. Thirty-two went on to receive a provisional or final diagnosis of autism spectrum disorders. Fifty-six were later diagnosed with language delay, nine were diagnosed with developmental delay, and 36 received "other" diagnoses. Fifty-one infants who failed the screen were "false-positives" and developed normally.

"This study is very encouraging in showing that a quick questionnaire given to parents during a well-baby visit has potential for identifying infants at risk for autism, as well as other developmental delays, at 12 months of age," said Geraldine Dawson, chief scientific officer of the non-profit organization Autism Speaks.

Some pediatricians worry the high false-positive rate could cause parents undue stress and unnecessary medical costs. But others think the early checklist could help educate parents about signs of autism.

"As pediatricians, we only get a snapshot of a child's development during an office visit. We rely on parents to bring concerns to our attention," Dr. Ari Brown, an Austin-based pediatrician at and co-author of "Expecting 411."

Brown said the survey might not be sensitive enough to detect children on the mild end of the spectrum, but thinks the tool could help parents know what to look out for.

"The better we can educate families about normal development and abnormal development, the sooner a child can be diagnosed and begin treatment."

Linda Powell, whose son Samuel is now 13 and doing well thanks to early detection and intervention, said she is grateful that she acted on her intuition. She said first-time moms don't always know what's normal and may think their babies will grow out of unusual behaviors.

"When new parents leave the hospital with their newborn they should have a checklist," she said. "Early detection and therapy will help so many of these children because they're so bright."