Autism in community pre-schoolers: developmental profiles.
Community screening flags preschoolers with ASD who usually bring severe language delays and often intellectual disability.
01Research in Context
What this study did
Anne-Schweizer et al. (2013) screened 129 preschoolers in the community for autism.
They used standard tests to see who met ASD criteria and what other delays showed up.
Kids were one to four years old and lived in the same city.
What they found
Seventy-seven percent of the children met the cut-off for autism spectrum disorder.
More than half had little or no useful speech.
About one in three also had intellectual disability and one in three showed hyperactivity.
How this fits with other research
Rivard et al. (2015) looked at almost the same age group and found the same rate of ID: about one in three.
Vassos et al. (2016) later showed that, after early intervention, roughly one fourth of preschoolers with ASD still speak very little.
This matches the 56% minimal language seen in the target study and tells you to plan for long-term communication goals.
Barbaro et al. (2012) studied even younger toddlers and found the receptive–expressive gap is already clear by 18–24 months, so screening can start earlier.
Why it matters
If you run intake for preschool ABA, expect most kids to arrive with ASD plus language and cognitive delays.
Screen both receptive language and non-verbal IQ at the start and write goals that pair communication with adaptive skills.
Use the data to explain to parents why therapy may last longer than planned.
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02At a glance
03Original abstract
Autism is often a complex developmental disorder. The aim of the present study was to describe the developmental characteristics of 129 1-4-year-old children (102 boys, 27 girls) referred for clinical assessment (mean age 2.9 years) due to suspicion of autism spectrum disorder (ASD) after community screening at Child Health Care centers. All children were clinically assessed at the Child Neuropsychiatry Clinic (CNC) in Gothenburg by a research team (neurodevelopmental examination, structured interviews and general cognitive and language examinations). Of the 129 children, 100 met diagnostic criteria for ASD (69 with autistic disorder, and 31 with atypical autism/pervasive developmental disorder-not otherwise specified). The remaining 29 children had a variety of developmental disorders, most often attention-deficit/hyperactivity disorder (ADHD), language disorder, borderline intellectual functioning, and intellectual developmental disorder (IDD) with (n=25) or without (n=4) autistic traits (AT). IDD was found in 36% of the 100 children with ASD, and in 4% of the 25 children with AT. Of the children with ASD, 56% had language disorder with no or just a few words at the initial assessment at the CNC, many of whom in combination with IDD. Hyperactivity was found in 37% of those with ASD and in 40% of those with AT. Epilepsy was found in 6% of the total group and in 7% of those with a diagnosis of ASD. Of the latter group 11% had a history of regression, while none of the AT cases had a similar background. When results were compared with a non-screened preschool ASD group of 208 children, referred for ASD intervention at a mean age of 3.4 years, very similar developmental profiles were seen. In conclusion, early community ASD screening appears to systematically identify those children who are in need of intervention and follow-up.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.06.016