Autism screening at age one gets mixed reception

AUSTRALIAN experts have urged caution following US research suggesting screening for autism spectrum disorders (ASD) can begin as early as age one year.

Paediatricians in the US screened 10,479 infants at their one-year check-up using a five-minute parent report questionnaire, finding 184 who required evaluation.

Thirty-two of the infants received a provisional or final diagnosis of ASD and 56 of language delay, with the researchers estimating a positive predictive value of the screen of 75%.

“The opportunity to begin the treatment of autism specifically around the first birthday, an age when brain growth is altered… seems to have potential to change outcome for affected children,” the authors said.

But Melbourne clinical psychologist Professor Margot Prior, from La Trobe University, said it would be rare to obtain a reliable diagnosis at such a young age.

“The earliest we would feel comfortable would be 18 months and even then we’d want to see them again at two,” she said.

Psychologist Dr Kylie Gray (PhD), from the Monash Centre for Developmental Psychiatry and Psychology, said while early identification of children was important, screening at one year was difficult.

Meanwhile, in an unrelated study, US paediatricians have suggested autism screening for preterm infants may need to wait until at least 30 months of age.

In a presentation at the Pediatric Academic Societies’ annual conference, researchers showed in a study that 18% tested positive for autism at 18 months (age-corrected for prematurity) and 10% were positive at age-corrected 30 months.

Only 3% had positive results on three different screening scales at both ages, and all of these children were later diagnosed with ASD.

J Pediatr 2011, online 29 April

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