Screening for autistic spectrum disorder in children aged 14-15 months. II: population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings.
Two-step baby screening at 14 months catches autism early and still works when you swap in newer, shorter tools.
01Research in Context
What this study did
Dietz et al. (2006) ran a two-step screening program for autism in babies. They gave the 19-item ESAT to parents of 31,724 infants at the 14-month check-up. Kids who failed the first step saw a specialist for a full assessment.
What they found
The screen caught 18 children with ASD. It also flagged many kids who had other delays, not autism. The team says the two-step flow works and should start before 18 months.
How this fits with other research
Srisinghasongkram et al. (2016) copied the two-step idea using the M-CHAT in Thai toddlers. They also got strong numbers, showing the method travels across cultures and tools.
Nah et al. (2019) trimmed the idea even further. Their 5-item brief ADEC gives 81 % accuracy and takes only two minutes. It keeps the early-age spirit but saves time.
Pandey et al. (2008) looked at the M-CHAT in low-risk toddlers and saw more misses at 18 months than at 24. That warns us: one screen at 14 months may need a second look later.
Why it matters
You can add the ESAT—or any short two-step screen—to your 12-15 month well-baby visits. Flag early, refer early, and watch for other delays in the false-positive group. Pair the first screen with a repeat at 24 months to catch the kids who slip through.
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02At a glance
03Original abstract
A two-stage protocol for screening for autistic spectrum disorders (ASD) was evaluated in a random population of 31,724 children aged 14-15 months. Children were first pre-screened by physicians at well-baby clinics using a 4-item screening instrument. Infants that screened positive were then evaluated during a 1.5-h home visit by a trained psychologist using a recently developed screening instrument, the 14-item Early Screening of Autistic Traits Questionnaire (ESAT). Children with 3 or more negative scores were considered to be at high-risk of developing ASD and were invited for further systematic psychiatric examination. Eighteen children with ASD were identified. The group of children with false positive results had related disorders, such as Language Disorder (N = 18) and Mental Retardation (N = 13).
Journal of autism and developmental disorders, 2006 · doi:10.1007/s10803-006-0114-1