Practice Parameter: Screening and Diagnosis of Autism. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society
Neurology
Filipek, P. A., Accardo, P. J., et al. (2000).
Neurology, 55(4), 468-479.
This guideline provides recommendations for screening and assessment of autism in children.
Quality Standards Subcommittee of the American Academy of Neurology
American Academy of Audiology; American Academy of Pediatrics; American Occupational Therapy Association; American Psychological Association; American Speech–Language–Hearing Association; Autism National Committee; Cure Autism Now; National Alliance for A
"Screening specifically for autism should be performed on all children failing routine developmental surveillance procedures using one of the validated instruments—the CHAT [Checklist for Autism in Toddlers] or the Autism Screening Questionnaire" (Guideline; p. 5).
<p>"Further developmental evaluation is required whenever a child fails to meet any of the following milestones:</p>
<ul>
<li>babbling by 12 months,</li>
<li>gesturing (e.g., pointing, waving bye-bye) by 12 months,</li>
<li>single words by 16 months,</li>
<li>two-word spontaneous (not just echolalic) phrases by 24 months, and</li>
<li>loss of any language or social skills at any age" (Guideline; p. 5).</li>
</ul>
"Laboratory investigations recommended for any child with developmental delay and/or autism include[s] audiologic assessment.... Early referral for a formal audiologic assessment should include behavioral audiometric measures, assessment of middle ear function, and electrophysiologic procedures using experienced pediatric audiologists with current audiologic testing methods and technologies" (Guideline; p. 5).
"Screening [of siblings of children on the autism spectrum] should be performed not only for autism-related [characteristics] but also for language delays, learning difficulties, social problems, and anxiety or depressive symptoms" (Guideline; p. 5).
"Recommended developmental screening tools include the Ages and Stages Questionnaire, the BRIGANCE® Screens, the Child Development Inventories, and the Parents' Evaluations of Developmental Status [PEDS] (Guideline; p. 5). Because of the lack of sensitivity and specificity, the Denver-II (DDST-II) and the Revised Denver Pre-Screening Developmental Questionnaire (R-DPDQ) are not recommended for appropriate primary-care developmental surveillance" (Guideline; p. 5).
"A comprehensive speech-language-communication evaluation should be performed on all children who fail language developmental screening procedures by a speech-language pathologist with training and expertise in evaluating children with developmental disabilities. Comprehensive assessments of both preverbal and verbal individuals should account for age, cognitive level, and socioemotional abilities, and should include assessment of receptive language and communication, expressive language and communication, voice and speech production, and in verbal individuals, a collection and analysis of spontaneous language samples to supplement scores on formal language tests" (pp. 8-9).
<p>The various diagnostic parental interviews and diagnostic observation instruments are recommended:</p>
<ul>
<li>"Diagnostic parental interviews:</li>
</ul>
<ul>
<ul>
<li>The Gilliam Autism Rating Scale,</li>
<li>The Parent Interview for Autism,</li>
<li>The Pervasive Developmental Disorders Screening Test–Stage 3, and</li>
<li>The Autism Diagnostic Interview–Revised.</li>
</ul>
</ul>
<ul>
<li>Diagnostic observation instruments:
<ul>
<li>The Childhood Autism Rating Scale,</li>
<li>The Screening Tool for Autism in Two-Year-Olds, and</li>
<li>The Autism Diagnostic Observation Schedule-Generic" (p. 8).</li>
</ul>
</li>
</ul>
