5-Minute Screening Identifies Subtle Signs Of Autism In 1-Year Olds

A five-minute checklist that parents can fill out in pediatrician waiting rooms may someday help in the early diagnosis of autism spectrum disorder (ASD), according to a study funded by the National Institutes of Health. Published today in the Journal of Pediatrics, the study’s design also provides a model for developing a network of pediatricians to adopt such a change to their practice.

“Beyond this exciting proof of concept, such a screening program would answer parents’ concerns about their child’s possible ASD symptoms earlier and with more confidence than has ever been done before,” noted Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), part of NIH.

Identifying autism at an early age allows children to start treatment sooner, which can greatly improve their later development and learning. However, many studies show a significant delay between the time parents first report concerns about their child’s behavior and the eventual ASD diagnosis, with some children not receiving a diagnosis until well after they’ve started school.

Recognizing the need to improve early ASD screening, Karen Pierce, Ph.D., of the University of California, San Diego, and colleagues established a network of 137 pediatricians across San Diego County. Following an hour-long educational seminar, the pediatricians screened all infants at their 1-year, well-baby check-up using the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, a brief questionnaire that detects ASD, language delay, and developmental delay. The questionnaire asks caregivers about a child’s use of eye gaze, sounds, words, gestures, objects and other forms of age-appropriate communication. Any child who failed the screen was referred for further testing and was re-evaluated every six months until age 3.

Out of 10,479 infants screened, 32 were identified as having ASD. After excluding for late onset and regression cases, this is consistent with current rates that would be expected at 12 months, according to the researchers. When including those identified as having language delay, developmental delay, or some other form of delay, the brief screen provided an accurate diagnosis 75 percent of the time.

Following the screen, all toddlers diagnosed with ASD or developmental delay and 89 percent of those with language delay were referred for behavioral therapy. On average, these children were referred for treatment around age 17 months. For comparison, a 2009 study using data from the Centers for Disease Control and Prevention found that, on average, children currently receive an ASD diagnosis around 5.7 years (68.4 months) of age, with treatment beginning sometime later.

In addition to tracking infant outcomes, the researchers also surveyed the participating pediatricians. Prior to the study, few of the doctors had been screening infants systematically for ASD. After the study, 96 percent of the pediatricians rated the program positively, and 100 percent of the practices have continued using the screening tool.

“In the context of a virtual lack of universal screening at 12 months, this program is one that could be adopted by any pediatric office, at virtually no cost, and can aid in the identification of children with true developmental delays,” said Dr. Pierce.

The researchers note that future studies should seek to further validate and refine this screening tool, track children until a much older age, and assess barriers to treatment follow up.

This study was also supported by an NIMH Autism Center of Excellence grant as well as Autism Speaks and the Organization for Autism Research.

The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit <http://www.nimh.nih.gov>.

REFERENCE:
Pierce K, Carter C, Weinfeld M, Desmond J, Hazin R, Bjork R, Gallagher N. Catching, Studying, and Treating Autism Early: The 1-Yr Well-Baby Check-Up Approach. J Pediatr. 2011 Apr. [Epub ahead of print]

Source: NIH News Release

DAGMEC Resident Research Forum Scheduled April 28

The Dayton Area Graduate Medical Education Community (DAGMEC) will present its 12th annual Resident Research Forum on Thursday, April 28, from 5:00-7:00 p.m.  Fifty-eight posters will be on display highlighting original research projects conducted by residents and fellows from Dayton area training programs. Awards will be presented at 6:40 p.m. and appetizers and other refreshments will be available.

The event will be held at the Webster Street “Top of the Market” Banquet Center, 32 Webster Street, in Dayton.  Directions can be found at http://www.topofmarket.com/directions.html.

This event is open to residents, fellows, faculty, attending physicians, medical students and other health care professionals.  No RSVPs are necessary. DAGMEC encourages you to stop by and support these research efforts.

Your Invitation to the Medical Student Research Symposium – April 21

All BSOM students and faculty are invited to attend the 3rd annual Medical Student Research Symposium on Thursday, April 21, from 5:45-8:00 p.m. in White Hall on the WSU main campus.

The symposium opens at 5:45 p.m., when 29 student research posters will be available for viewing in the White Hall Atrium. It continues at 6:00 p.m. in 101 White Hall  (Gandhi Auditorium) with welcoming remarks and the inaugural Distinguished Scholar Lecture. A poster reception follows at 6:30 p.m. in the Atrium.

The Distinguished Scholar Lecture will be presented by Katie Bullinger, an M.D./Ph.D. candidate who graduates this year from Wright State University Boonshoft School of Medicine.  She completed her Ph.D. research in neuroscience in 2009 in the laboratory of Timothy Cope, Ph.D. After graduation, she will begin a one-year transitional residency at Kettering Medical Center followed by a residency in interventional neurology at Emory University. At the first Medical Student Research Symposium in 2009, Bullinger won awards for Best Overall Poster and Best Presentation.

The symposium is organized by the Wright State Medical Student Research Club with support from the BSOM Office of Research Affairs.

For more information about the Medical Student Research Symposium, contact Adam Deardorff (deardorff.2@wright.edu). Read more about previous symposia: 2009 | 2010.