Screening for Autism Spectrum Disorder in Young Children: Still Not Enough Evidence

Area of Science:

• Developmental Pediatrics
• Child Psychology
• Neurodevelopmental Disorders

Background:

• Early detection of autism spectrum disorder (ASD) can mitigate its impact.
• Previous reviews indicate limited evidence supporting ASD screening programs in young children.

Purpose of the Study:

• To update evidence on the diagnostic stability of ASD in young children.
• To evaluate the accuracy of ASD screening tools for young children.
• To assess the benefits of early interventions for screen-detected young children with ASD.

Main Methods:

• Systematic review of 33 studies.
• Analysis of diagnostic stability, screening tool accuracy (including M-CHAT versions), and early intervention outcomes.
• Assessment of study bias, including blinding, sample size, and follow-up duration.

Main Results:

• Diagnostic stability estimates varied (71.9%-100%), with most studies having short follow-up and high risk of bias.
• Screening tool accuracy data from 25 studies showed variable sensitivity (0.67-1.0), often with high risk of bias.
• Limited evidence of significant improvements from early interventions in screen-detected children.

Conclusions:

• Current evidence on ASD screening, diagnostic stability, and early interventions in young children is not conclusive.
• Future research requires blinded diagnostic assessments, longer follow-up periods, and reduced attrition to improve reliability.