Recommending Autism Detection in Early Childhood (ADEC) for use in low- and middle-income countries

Early detection of autism spectrum disorder (ASD) is vital for early intervention; however, access to feasible and reliable screening tools remains a challenge in many low- and middle-income countries. The purpose of this letter is to highlight Autism Detection in Early Childhood (ADEC), a play-based observational and clinician-administered instrument for children aged 12-36 months with strong cross-cultural evidence of validity, specificity, and sensitivity. We are pleased to announce that, for the first time since its development in 2007, ADEC is now freely available to clinicians and researchers worldwide. LAY ABSTRACT: Early autism identification is crucial to help children and families access services and interventions early, which are more likely to be effective (Wankhede et al., 2024; Sadeghi et al., 2019; Sadeghi and Pouretemad, 2022). Many low- and middle-income countries, however, lack access to commonly used autism screening and diagnostic tools because these tools are costly, time-consuming, or require extensive training. Consequently, diagnosis and treatment may be delayed. The Autism Detection in Early Childhood (ADEC) is a short, play-based observational assessment for children between the ages of 12 and 36 months. It consists of 16 items that address social, communication, and behavioral aspects of autism. It has been demonstrated that the ADEC can accurately identify autistic children in multiple countries, including the United States, Mexico, Ecuador, Indonesia, and Japan. The brief and virtual versions of the tool is also available, making it suitable for use in clinics, telehealth services, and remote or underserved settings. It's our pleasure to announce that the ADEC is now available free and openly for clinicians and researchers worldwide for the first time since its development in 2007. The ADEC offers a practical, reliable, and cost-effective option for early autism detection by removing financial and access barriers. This tool can be used and further validated by clinicians and researchers worldwide, especially in developing countries, to improve early identification of autism.