Detection of Early Warning Signs in Autism Spectrum Disorders: A Systematic Review

José María Salgado-Cacho,Yolanda De Diego-Otero,María Del Pilar Moreno-Jiménez

doi:10.3390/children8020164

Abstract

Due to the exponential increase of autism spectrum disorders’ prevalence in Western countries, it is necessary to improve early detection and intervention to enhance developmental milestones. This systematic review identified the most effective screening instrument, which can be used at an early age and which identifies the maximum number of autism cases. We identified several instruments with adequate predictive properties—the Autism Parent Screen for Infants (APSI), Battelle Development Inventory, second edition (BDI-2); Brief Infant-Toddler Social and Emotional Assessment (BITSEA); First Year Inventory (FYI); Infant-Toddler Checklist/Communication and Symbolic Behavior Scales Developmental Profile (ITC/CSBS-DP); Program of Research and Studies on AUTISM (PREAUT-Grid); Checklist for Early Signs of Developmental Disorders (CESDD); Social Attention and Communication Study (SACS); and the Screening Tool for Autism in Toddlers and Young Children (STAT)—that can be applied from 12 months of age in Western countries. The ITC/CSBS-DP has been proposed for universal screening from 12 months of age onwards, complemented by the Modified Checklist for Autism in Toddlers, Revised/Revised with Follow-Up (M-CHAT-R/F), which can be used from 15 months of age onwards. This strategy could improve early detection in at-risk children within the current health system, thus allowing for early intervention.

Highlights

Autism spectrum disorders (ASDs) are neurodevelopmental pathologies that manifest as deficits in certain fundamental areas
The search was performed using the combination of keywords: (“autism spectrum disorder (ASD)” OR “autism”) AND (“specificity”) AND (“positive predictive value” OR “Positive Predictive Value (PPV)”) AND (“identification” OR “screen*” OR “early screening” OR “early diagnosis” OR “early detection” OR “early identification”) AND (“tool” OR “instrument”); these terms may be found in the keywords, title, or summary of the article
There is a pressing need to improve the early detection of autistic spectrum disorders, but we need to keep in mind that a very early detection means assuming a higher number of false positives, so the ethical implications of an early detection program must be taken into account

Summary

Introduction

Autism spectrum disorders (ASDs) are neurodevelopmental pathologies that manifest as deficits in certain fundamental areas. Considering data from the last decades, several studies have been published to support the hypothesis of an increased number of ASD cases. The most recent published study indicated that ASD prevalence was 13.4 per 1000 children aged 4 years in 2010, 15.3 in 2012, and 17.0 in 2014. It has been proposed that the average age of diagnosis is three or four years of age, or even later for children of low socioeconomic status or without a previous family history of ASD. The period between initial suspicion of ASD and final diagnosis can be a stressful and confusing time for families, and early identification and intervention can address this issue [3]. In retrospective reports, most parents of children with ASD recall concerns regarding their child’s development after the first year of life [5]

Objectives

Methods

Results

Discussion

Conclusion