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Who We Are | Concerns About a Child | Screening | Diagnosis & Treatment
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Screening Tools

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.

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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.

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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.

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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.

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Last update: 01/06/12
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