The Early Screening for Autism and Communication Disorders: Field-testing an autism-specific screening tool for children 12 to 36 months of age

Abstract

There is a critical need for validated screening tools for autism spectrum disorder in very young children so families can access tailored intervention services as early as possible. Few screeners exist for children between the recommended screening ages of 18–24 months. This study examined the utility of a new autism-specific parent-report screening tool, the Early Screening for Autism and Communication Disorders for children 12–36 months. Field-testing was conducted from five sites with 471 children screened for communication delays in primary care or referred for familial risk or concern for autism spectrum disorder. The Early Screening for Autism and Communication Disorders was evaluated in three age groups: 12–17, 18–23, and 24–36 months. A best-estimate diagnosis of autism spectrum disorder, developmental delay, or typical development was made. Receiver operating characteristic curves were examined for all 46 items and the 30 items that best discriminated autism spectrum disorder from the non-spectrum groups. Area under the curve estimates for the total were greater than 0.90 across age groups. Cutoffs were established for each age group with sensitivity between 0.86 and 0.92 and specificity between 0.74 and 0.85. Results provide preliminary support for the validity of the Early Screening for Autism and Communication Disorders as an autism-specific screener in children 12–36 months with elevated risk of communication delay or autism spectrum disorder. Lay abstract There is a critical need for accurate screening tools for autism spectrum disorder in very young children so families can access tailored intervention services as early as possible. However, there are few screeners designed for children 18–24 months. Developing screeners that pick up on the signs of autism spectrum disorder in very young children has proved even more challenging. In this study, we examined a new autism-specific parent-report screening tool, the Early Screening for Autism and Communication Disorders for children between 12 and 36 months of age. Field-testing was done in five sites with 471 children screened for communication delays in primary care or referred for familial risk or concern for autism spectrum disorder. The Early Screening for Autism and Communication Disorders was tested in three age groups: 12–17, 18–23, and 24–36 months. A best-estimate diagnosis of autism spectrum disorder, developmental delay, or typical development was made. Analyses examined all 46 items and identified 30 items that best discriminated autism spectrum disorder from the non-spectrum groups. Cutoffs were established for each age group with good sensitivity and specificity. Results provide preliminary support for the accuracy of the Early Screening for Autism and Communication Disorders as an autism-specific screener in children 12–36 months with elevated risk of communication delay or autism spectrum disorder.

Prenatal exposure to pesticide residues in the diet in association with child autism‐related traits: Results from the EARLI study

“…Quantitative ASD phenotype in the child was captured by the original preschool version of the SRS (Constantino & Gruber, 2005, 2012), administered to mother participants when the child was 36 months (Miller et al, 2021; Sacrey et al, 2021; Wetherby et al, 2021; Zwaigenbaum et al, 2015; Zwaigenbaum et al, 2019). The SRS generates a total raw score ranging from 0 to 195, where higher values indicate greater expression of the ASD‐related phenotype.…”

Tools for early screening of autism spectrum disorders in primary health care – a scoping review

“…During the review process of the article, research on a new, promising screening tool—Early Screening for Autism and Communication Disorders (ESAC) was published. ESAC consists of 46 items, covers children between 12–36 months and has a reliability ranged from 0.92 to 0.95, sensitivity between 0.86 and 0.92 and specificity between 0.74 and 0.85 in an American population [ 157 ].…”

Quickstart for toddlers with autism spectrum disorder: A preliminary report of an adapted community-based early intervention program

“…Toddlers received screening and/or assessments for ASD from community-based pediatricians, registered psychologists, or a developmental pediatrician at a children's treatment center. Specific diagnostic and screening tools used were not recorded because we only required a positive indication of ASD risk at the entry for every child that enrolled; at enrollment, all toddlers received and screened positive on the ESAC ( Wetherby et al, 2021 ). There was no difference in wait time to begin QuickStart for children who had not yet received an ASD diagnosis and those who had.…”