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Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value?

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Abstract

Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n = 167) and age, gender, and practice-matched children passing screens (n = 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development.

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Acknowledgments

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health Award Number R44MH085399 and Health Award Number R44HD104973. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. The participating primary care pediatricians and their respective office staff are acknowledged for their cooperation during the project and continuing implementation. We acknowledge the testers including Ruth Williams, MA, Katherine Campe, MS, Jaime Allison, MEd, Margaret DeRamus, MS, and Tiffany Garner, PsyD with Trellis Services. We also acknowledge Linda Lee who created illustrations for Q-CHAT-10 items.

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Author notes

  1. Shana Attar

    Present address: University of Washington, Seattle, WA, USA

Authors and Affiliations

  1. Center for Promotion of Child Development Through Primary Care, Baltimore, MD, 6017 Altamont, USA

    Raymond Sturner, Kerry Bet & Lydia Stewart-Artz

  2. Pediatrics Department, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Raymond Sturner & Barbara Howard

  3. Foresight Logic, St. Paul, MN, USA

    Paul Bergmann

  4. CHADIS, Baltimore, MD, USA

    Barbara Howard, Kerry Bet & Shana Attar

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  1. Raymond Sturner
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  3. Barbara Howard
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Contributions

Raymond Sturner and Barbara Howard conceptualized, designed, and oversaw data collection during the study, drafted the initial manuscript, and approved the final manuscript as submitted. Lydia Stewart-Artz and Kerry Bet managed data collection and data entry, coordinated with offices, reviewed the manuscript and approved the final manuscript as submitted. Shana Attar performed autism and developmental evaluations, entered autism diagnostic conclusions, helped prepare the data for analysis, reviewed the manuscript and approved the final manuscript as submitted. Paul Bergmann helped design the project, carried out the analyses, reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Raymond Sturner.

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Sturner, R., Bergmann, P., Howard, B. et al. Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value?. J Autism Dev Disord 53, 3065–3076 (2023). https://doi.org/10.1007/s10803-022-05541-y

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