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How Pediatricians Screen for Autism

Your child's pediatric primary health care provider will start screening your baby for signs of developmental or communication challenges like autism spectrum disorder (ASD) at his or her very first well-child visit

They observe how your baby giggles, looks to you for reassurance, tries to regain your attention during a conversation, points or waves, responds to his or her name, and cries. It is those observations―in combination with family history, health examinations, and parents' perspectives―that help pediatric primary health care providers identify children at risk for ASD.

ALL children should receive a formalized ASD screening at their 18- and 24-month well-child visits:

The American Academy of Pediatrics (AAP) recommends screening all children for ASD at the 18 and 24-month well-child visits in addition to regular developmental surveillance and screening. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. For screening to be effective, it must be applied to all children – not only those with symptoms.

There are multiple different tools your provider can choose to screen for ASD. While the AAP does not endorse any specific ASD screening tool over another, here are some your child's provider may use:

  • Ages and Stages Questionnaires SE-2 (ASQ-SE2)

  • Pervasive Developmental Disorders Screening Test-II (PDDST-II)

  • Communication and Symbolic Behavior Scales (CSBS)

  • Modified Checklist for Autism in Toddlers – Revised with follow-up (M-CHAT-R/F)

The M-CHAT-R/F the most common screening tool used in pediatric offices.

It is a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening tool, pediatricians will be prompted to start conversations about language delays, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.

Screening isn't diagnosing!

It's important to note that screening isn't diagnosing.

  • If your child has a positive screen for an ASD, it doesn't mean he or she will be diagnosed on the spectrum. See If Autism is Suspected, What's Next?

  • If your child screens normally but you continue to worry about ASD, don't be shy. Screening tests are just that—screening—and don't identify all children with ASD.

The rate of success for the M-CHAT -R/F, for example, is not 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance.

If you are concerned and your child has not been formally screened:

Talk with your pediatric primary health care provider about doing a formal screening.

But know this: If you are concerned about your child's communication or behavior due to a family hi story of ASD, the way he or she talks or acts, or other people's comments about his or her behavior, trust your instincts. Don't wait to talk with your child's doctor about doing more. Before you go to the appointment, complete a free developmental milestone checklist, and read these tips about "How to Talk with the Doctor."

You know your child best and your concerns are important. If the first doctor doesn't respond to you or take you seriously, get a second opinion.

Don't wait. Acting early can make a big difference in your child's development!

Additional Information:


Last Updated
12/16/2019
Source
American Academy of Pediatrics (Copyright © 2019)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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