In a boost for early detection programs, a US study shows autism can be diagnosed with a high level of accuracy in toddlers as young as 14 months
A US study showing that autism can be diagnosed with a high level of accuracy in toddlers as young as 14 months lends even more credibility to Australiaâs early detection programs. Â
Californian researchers found that a diagnosis of autism made at 14 months of age was sustained at three years of age in 79% of cases, climbing to an 83% accuracy rate in toddlers diagnosed at 16 months.
Currently, Australian GPs are advised to watch for âred flagsâ for autism in toddlers using questionnaires, such as the Modified Checklist for Autism in Toddlers-Revised (M-CHAT).
But there has been some hesitancy around using these diagnostic assessments before children reach the age of two, Andrew Whitehouse, a professor of autism at the Telethon Kids Institute, said.
âThis study certainly could change practice,â he said. âWe have just been thinking that two years of age is the youngest that we can go.â
The most exciting aspect of the study was that it employed existing diagnostic tools that were used in clinics âevery day, all day, all over Australiaâ, Professor Whitehouse said.
These included the ADOS-2, the Mullen Scales of Early Learning and Vineland Adaptive Behavior Scales.
âThereâs no doubt that we can diagnose young children with autism with a high degree of certainty,â Emeritus Professor Bruce Tonge, a child psychiatrist affiliated with Monash University in Melbourne, said. âBut we still have to be careful, because 83% is not every child.â
Toddlerâs brains developed extraordinarily rapidly, so every month that passed without intervention for autism was a missed opportunity to radically transform the trajectory of that childâs life, Professor Tonge added.
âWe have increasing evidence that early intervention can make a difference,â he said. âIt doesnât cure autism, but it makes the impact of the symptoms of autism less problematic.
âFor example, if you can teach a young child with autism who canât talk to use visual ways of communicating, that will avoid the necessity of the child having to have a meltdown or a tantrum because they canât get their message through.â
The US study of around 1,200 toddlers found that autism couldnât be reliably detected before a childâs first birthday.
That made sense because it was very difficult to measure autism-related behaviour in infants, Professor Whitehouse said. âThereâs not a lot for us to observe,â he said.
What should raise those red flags for autism were notable absences of social behaviours at six, 12 and 18 months â âno signs of play, no reciprocal gestures like beginning to wave or point socially, or a lack the early development of language or verbal communication, such as babblingâ â Professor Tonge said.
JAMA Pediatrics, online 29 April