Screening for Autism Autistic spectrum disorders (autism, pervasive developmental disorder, not otherwise specified (PDD-NOS) and Asperger disorder) are much more common than previously thought. Latest statistics show that autism spectrum disorders affect as many as six out of one thousand children (http://aapnews.aappublications.org/). It is important for pediatricians to screen for this disorder because early intervention (EI) can maximize potential outcome. The AAP has published an excellent position paper on developmental screening and surveillance (http://pediatrics.aappublications.org/cgi/content/full/118/1/405#F1). The AAP statement recommends screening for Autism Spectrum Disorders at 18 months and then again at 24 months. We suggest that these screenings should be done with either the CHAT (chat.pdf) or M-CHAT (m-chat.pdf).
The CHAT is a simple screening tool that combines parental report
and observations of the child. It aims to
identify children who are at risk for social-communication disorders.
A few toys are necessary for administration and it can be easily
adapted to the individual practitioner’s style.
The M-CHAT is a parent questionnaire that is reviewed by the
practitioner or office staff. Scoring
for both tools is simple and straightforward (CHAT
scoring.pdf and MCHAT scoring.pdf).
The key items look at behaviors which, if absent
at 18 months, put a child at risk for a social-communication disorder.
These behaviors are joint attention, including pointing to show and
gaze monitoring (e.g. looking to where a parent is pointing), and pretend
play (e.g. pretending to pour tea from a toy teapot). If autism spectrum disorder is suspected, the child should be referred to EI and for further neuro-developmental evaluation. Consider a Developmental-Behavioral Pediatric or additional medical evaluation. It should be noted that mild cases of ASD might be missed by these tools. For additional information on tests to identify autism please see: http://www.health.state.ny.us/community/infants_children/early_intervention/autism/screenin.htm Please refer to the following link for research on the CHAT: http://www.autismresearchcentre.com/docs/papers/2000_BCetal_CHAT.pdf
|