Are Office Observations Sufficient to Decide on an Autism Referral?

In blinded observations, experts failed to identify 39% of toddlers with an autism diagnosis.

The American Academy of Pediatrics recommends screening all children for autism spectrum disorder (ASD) at ages 18 and 24 months using a standardized questionnaire (NEJM JW Pediatr Adolesc Med Jan 23 2008). Most pediatric practices use the Modified Checklist for Autism in Toddlers Revised (M-CHAT-R).

Alternatively, is a clinical observation during a well-child care visit sufficient?

Parents of 796 toddlers (aged 15–33 months) receiving care in a suburban pediatric practice completed the M-CHAT and a developmental checklist. Those whose toddlers screened positive (at risk for ASD) were administered the M-CHAT follow-up interview. Fourteen children identified with early signs of ASD were diagnosed with ASD using the gold-standard test, the Auti…

Reviewing Author

Martin T. Stein, MD

Disclosures

Consultant / Advisory boardPearson Neuroscience Advisory Board

Speaker’s bureauAmerican Academy of Pediatrics

RoyaltiesElsevier, Inc.

Editorial boardsJournal of Developmental and Behavioral Pediatrics