Autism Screening: Where Do We Go From Here?

Abstract

* Abbreviations: ASD — : autism spectrum disorder M-CHAT/F — : Modified Checklist for Autism in Toddlers With Follow-up PPV — : positive predictive value The lengthy diagnostic odyssey experienced by families of children with autism spectrum disorder (ASD) remains a major barrier to early access to ASD therapeutic services. Although accelerating this process has been identified as a top priority,1 there is a polarized debate about whether ASD screening can accomplish this. The American Academy of Pediatrics recommends that all children be assessed by using an ASD screening tool at 18 and 24 months old.2 In contrast, the US Preventive Services Task Force concluded that there was “insufficient evidence to recommend screening for ASD in children aged 18 to 30 months for whom no concerns of ASD have been raised.”3 The issue has been debated passionately,4–6 but without resolution, in part because of limited community-level data regarding screening feasibility, accuracy, and outcomes. The current study by Guthrie et al7 contributes important findings that further inform this debate. The authors demonstrated that universal screening was feasible, with >90% of toddlers screened through a large primary care network by integrating the Modified Checklist for Autism in Toddlers (M-CHAT) With Follow-up (M-CHAT/F) into routine primary health care. Physicians were prompted to administer the … Address correspondence to Lonnie Zwaigenbaum, MD, MSc, Autism Research Centre, Glenrose Rehabilitation Hospital, University of Alberta, E209, 10230 111th Ave, Edmonton, AB T5G 0B7, Canada. E-mail: lonniez{at}ualberta.ca