Autism: Early Screening, Intervention Imperative

By Mahoney, Diana | Clinical Psychiatry News, September 2006 | Go to article overview

Autism: Early Screening, Intervention Imperative


Mahoney, Diana, Clinical Psychiatry News


When it comes to understanding autism, more questions remain than answers. But the importance of early intervention is a certainty.

Numerous studies have shown that appropriate behavioral interventions implemented early and aggressively in children diagnosed with autism or an autism spectrum disorder (ASD) can improve the daily and long-term functioning and intellectual development of these children.

Such interventions also have the potential to minimize the incidence or severity of comorbid mental health problems.

The ability to intervene early, however, hinges on early identification. And although mounting evidence shows that autism can be diagnosed in young toddlers and potentially in infants, evidence also shows that screening advances developed in academic research centers have yet to filter to clinical practice.

The complex and variable nature of autism and its related disorders certainly makes diagnosing these conditions difficult. Without definitive biological markers, clinicians are left to rely primarily on parental reports and direct observation.

Yet, despite the diagnostic obstacles, studies show that standardized tools can effectively screen for autistic behaviors in young children. For example, investigators in Hong Kong recently showed that an instrument called CHAT-23 was a highly sensitive and specific screen for autism in a cohort of 212 developmentally delayed Chinese children with mental ages of 18-24 months.

A combination of two earlier tests--the Checklist for Autism in Toddlers (CHAT) and the modified CHAT (mCHAT)--CHAT-23 consists of a self-administered parent questionnaire that addresses social interest, motor development, social play, pretend play, the use of pointing to ask for or show something, and rough-and-tumble play. Additionally, the measure includes a clinician observation component that looks at five actions: eye contact, ability to follow a point, and pretend play (Pediatrics 2004;114:el66-76).

Through the study, the investigators identified seven key questions on the parental questionnaire that could best discriminate autism from nonautism, addressing areas of joint attention, pretend play, social relatedness, and social referencing. Failing any two of the seven questions yielded a sensitivity of 0.931 and specificity of 0.768.

On the clinician observational component, all items but the block tower activity were found to discriminate autism from nonautism. Failing any two of the remaining four items produced a sensitivity of 0.736 and a specificity of 0.912.

The CHAT-23 and most other autism screening instruments were designed to screen children 18 months and older. New tools are being developed to screen younger children. In a landmark study in Canada, for example, researchers were able to pinpoint specific behavioral signs in infants as young as 12 months that can accurately predict whether a child will develop autism (Int. J. Devl. Neurosci. 2005;23:143-52).

The investigators developed an instrument called the Autism Observation Scale for Infants (AOSI) and tested it in a cohort of infant siblings of autistic children. The AOSI maps the development of infants as young as 6 months against 16 risk markers for autism.

According to Dr. Lonnie Zwaigenbaum, a developmental pediatrician at McMaster University in Hamilton, Ont., and one of the lead investigators in what is now called the Canada/U.S. Baby Sibs Research Consortium, the investigation showed that "the predictive power of these markers is remarkable." Within this high-risk group of children, "almost all of the children diagnosed with autism by age 2 had seven or more of the predictive markers by the time they were a year old," Dr. Zwaigenbaum said.

Certain behaviors that were present as early as age 6 months distinguished those children who were later diagnosed with autism from their nonautistic peers in the study. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Autism: Early Screening, Intervention Imperative
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.