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In our efforts to promote early identification of developmental disorders in
young children, First Signs has conducted an extensive review of
screening tools. This section serves as an overview of, and introduction to,
the practice of routine screening by pediatric clinicians.
In this section, you will find information about:
How are screening tools used? Screening tools are brief measures that differentiate children who are at risk
for atypical development from those who are not. They range from effective questionnaires
given to parents in waiting rooms to brief, but purposeful, give-and-take exchanges
and observations during pediatric exams. Often, screening tools can help eliminate
worries of developmental delays, by screening children “out,” rather
than “in.” Screening by itself does not provide a diagnosis, but is the first key step in
the diagnostic process. Therefore, it is important for health care providers
to immediately refer those flagged as “at risk” during screening to
diagnostic specialists for more extensive diagnostic evaluation and referral
for appropriate intervention. Please visit our
Screening Process section for
key guidelines about screening, referral, and diagnosis. Screening tools have applications for physicians, healthcare providers, clinics,
day care center providers, schools, parents, and others who work with young children.
Screening tools are available to identify a variety of concerns from broad-based
developmental disorders to autism spectrum disorders to other related disorders,
such as attention deficit disorder and bipolar disorder.
Our focus is autism and related disorders. Back to top Screening recommended at every well visit
In recent years, leading medical organizations have issued a number of policy
statements that provide guidelines for the screening and diagnosis of autism
spectrum disorder and call for routine developmental screening in young children.
In keeping with these statements, First Signs
recommends that a physician or
trained nurse practitioner perform a routine developmental screening at every
well visit starting at four months of age.
First Signs
recommends that primary care providers conduct developmental screening at every
well child visit (minimally, at all well visits between 12 and 36-months) for
any type of atypical development. If the developmental screening indicates a
concern, a simple autism screening should be performed, along with a formal audiological
assessment, a lead screen for pica, and a referral to Early Intervention and to
a an autism specialist for a developmental evaluation. If
the autism screening flags a potential problem, the child should be should be
referred to a specialist for formal diagnostic testing. Back to top Why are screening tools important? Screening tools encourage routine and systematic surveillance of developmental
milestones and concerns. Many high quality screening tools rely upon parent report,
which has been proven to increase screening tool accuracy. They stimulate dialogue
between practitioners and parents about the more subtle aspects of development—social, emotional,
and communication. Looking more carefully and
qualitatively at developmental milestones allows parents’ concerns to be addressed
in a timely manner and improves outcomes for all children, not just those challenged
by autism and developmental disorders. First Signs
recommends “sensitive” screening tools over screening tools
with high “specificity” (those proven to identify children at risk
vs. those that screen out children who are not at risk), since the prevalence
of children with autism spectrum and other childhood disorders is dramatically
on the rise. By identifying as many children as possible as early as possible,
effective interventions can begin immediately. Only with consistent and intensive
intervention, will children with autism and related disorders experience real
improvement. Back to top Screening tools and related information to help clinicians To assist physicians and other healthcare providers in the screening process,
First Signs
has provided information and ratings on several validated screening
tools that are brief, accurate, and cost-effective. The
Screening Tools section
gives physicians and other healthcare providers access to information about the
best screening tools currently available. Back to top
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