The challenges of screening pre-school children for autism spectrum disorders in Iran

Abstract

Purpose: Early identification and diagnosis of children with autism spectrum disorder is recommended, but this is difficult to achieve in less developed countries due to a lack of suitable tools and personnel. This two-phase study, undertaken in Iran, aimed to develop culturally appropriate and feasible means for screening pre-school children for autism spectrum disorder (ASD). Method: The first phase involved information and training events held in four cities to alert parents and to recruit and train professionals to undertake screenings and diagnostic assessments. In phase 2, a screening tool developed in Iran was administered to over 20 000 preschool children with the Iranian version of the GARS2 scale used to assess the probability of the child having ASD. Results: Over 250 professionals were trained and assessed as competent screeners of whom a further 67 were trained and accredited to use GARS2. They included postgraduate students and practitioners from a range of disciplines. In all, 1579 children screened positive; however, only 130 parents brought their child for the diagnostic assessment of whom 22% had a high probability of having ASD. Conclusion: The feasibility of undertaking a screening programme for ASD with Iranian preschoolers has been demonstrated although further research is needed to refine the screening and diagnostic tools, monitor assessors and promote greater engagement of families.Implications for RehabilitationSizeable numbers of postgraduate students and practitioners were recruited to assist with the screening and assessments of preschoolers.The uptake of screening was highest among parents of four and five years olds but much less so for younger children and in bringing children for further assessments.Further research is needed into the development of more suitable screening and diagnostic tools for ASD with Iranian preschoolers and the training of assessors in their use.