The screening and diagnosis of autistic spectrum disorders.

Feldman et al. (1999) pulled every paper on autism screening. They asked: what two-step process catches kids early and sends them to help fast?

The team wrote a consensus plan. Level 1: pediatricians watch all kids at regular check-ups. Level 2: kids who flag move to a full autism team.

The review showed most kids are found too late. The dual-level plan cuts wait time by giving clear red flags and a fast track to diagnosis.

The paper lists tools, ages, and referral steps. It tells doctors exactly what to watch for during 18- and 24-month visits.

Ricciardi et al. (2006) extends the 1999 plan. Their 4-item ESAT works at 14 months, pushing the first screen even earlier.

Mottron (2021) says the 1999 rule-based checklist is now outdated. They argue we should pick kids by clinician-rated prototypes, not strict criteria.

Bejarano-Martín et al. (2020) tested the 1999 pathway in 14 EU countries. Parents rated early services poorly, showing the plan often stalls in real clinics.

You can still use the two-level logic today. Start with a short parent screener like the 4-item ESAT or 5-item SRS at well-child visits. If risk shows, walk the family straight to your autism team. Track your own wait times; if families see 4+ providers like in Siklos et al. (2007), tighten your hand-offs.