1. |
Evidence supports the usefulness of ASD-specific screening at age 18 and 24 mo |
• Evidence supporting this statement is summarized in Table 1 of the article by Zwaigenbaum et al
17
on early screening. |
• ASD screening before age 24 mo may be associated with higher false-positive rates than screening at age ≥24 mo |
• Broadband screening in children aged <24 mo can also assist in early detection of ASD |
2. |
Siblings of children with ASD are at elevated risk for ASD and other developmental disorders and thus should receive intensified surveillance |
• With risk of ASD as high as 18%,
4
and of milder symptoms and/or developmental delays at ≥15%,
16
siblings of children with ASD are high-risk group |
3. |
Children identified through ASD-specific screening should be immediately referred for diagnostic evaluation and appropriate intervention |
• The potential benefits of a positive screen will be realized only if followed by consistent referral and timely access to specialized assessment and intervention services |
4. |
The long-term stability of ASD diagnosis in children ≥24 mo of age is well established |
• Evidence supporting this statement is summarized in Table 2 of the article by Zwaigenbaum et al
17
|
• Emerging data suggest that ASD diagnoses before 24 mo of age are stable, although further research is needed, particularly involving children identified via early screening |
5. |
Barriers to ASD-specific screening in the health care system need to be identified and removed to facilitate rapid diagnosis and early intervention |
• Reported barriers include insufficient time and/or reimbursement and other logistic challenges (eg, disruption of work flow, lack of office-based systems for making referrals) |
• Health care provider beliefs regarding the potential benefits and risks can also influence participation in screening programs |
6. |
Methodologically rigorous research in ASD-specific screening should be a high priority |
• Recommendations for future research include applying current screens in large diverse community samples to maximize generalizability, assessing clinically relevant outcomes (eg, age of diagnosis), follow-up of both screen-positive and screen-negative children, and more detailed sample characterization to better understand what factors may influence accuracy of screening |
7. |
There are several additional priorities for future ASD screening research |
• Considerations for future research also include incorporating combined broadband and ASD-specific screening, randomized designs, repeat screening, use of technology, biomarkers, and examining factors that may influence screening uptake and outcomes. |