Screening for autism spectrum disorders: state of the art in Europe

Abstract

A large number of studies have reported on the validity of autism spectrum disorder (ASD) screening procedures. An overall understanding of these studies' findings cannot be based solely on the level of internal validity of each, since screening instruments might perform differently according to certain factors in different settings. Europe has led the field with the development of the first screening tool and first prospective screening study of autism. This paper seeks to provide an overview of ASD screening studies and ongoing programmes across Europe, and identify variables that have influenced the outcomes of such studies. Results show that, to date, over 70,000 children have been screened in Europe using 18 different screening procedures. Differences among findings across studies have enabled us to identify ten factors that may influence screening results. Although it is impossible to draw firm conclusions as to which screening procedure is most effective, this analysis might facilitate the choice of a screening method that best fits a specific scenario, and this, in turn, may eventually improve early ASD detection procedures.

Issues in Identification and Assessment of Children with Autism and a Proposed Resource Toolkit for Speech-Language Pathologists

“…Based on reviews of screening studies, Charman and Gotham are opposed to ASD universal screening in children aged 5 years and younger because it increases costs, and the problem of overidentification with its corollary of causing anguish to parents of "failed" children. Nonetheless, researchers around the globe advocate for the detection of ASD between 9 and 24 months as it may lead to early treatment and improved outcomes for the affected child [72][73][74][75][76]. However, following an extensive review of screening accuracy, benefits, and potential harm of both early screening and early behavioral treatments, Siu [77] does not recommend early screening for children who have not been diagnosed with developmental delays and are not signaled by their caretakers.…”

Early detection of autism spectrum disorders: From retrospective home video studies to prospective ‘high risk’ sibling studies

“…In fact the choice between a higher sensitivity (lower number of false negatives) or a higher specificity (lower number of false positives) is a major issue, and the extensive time-consuming specialized assessment for the false positives and the significant delay of the diagnosis for the false negatives, need to be taken into account (Dereu et al, 2012). Due to recent recognition of importance of an early identification related to early intervention for improving outcome, the general tendency in developing cut offs for screening instrument is to increase specificity: in fact, it is important to consider the number of false positives (children with another developmental disorder) who could eventually benefit from a diagnostic evaluation (García-Primo et al, 2014). Thus, the signs that were identified by these tools are neither universal, nor necessarily specific to ASD and the understanding of how ASD develops from the first months of life, across infancy, and how it can be distinguished from other developmental disorders early on, is still a subject of great interest, which has been addressed by several groups of researchers around the world.…”

La detección e intervención tempranas en menores con trastorno del espectro autista

“…La presencia del programa del "Niño sano", en España, por ejemplo, es un marco incomparable frente a países donde no cuentan con dicho programa y donde se limitan a administrar herramientas de cribado a niños ya considerados de riesgo por otras vías García-Primo et al, 2014). Es importante valorar si este tipo de programas está disponible a toda la población y si cubre familias de todos los grupos socioeconómicos y culturales.…”