On average, half of the families of children with autism spectrum disorder are aware of children’s unusual behavior after 18 months of age. At this point, the autism screening tests performed at an early stage is of great importance. Think about that your child is behaving in a disturbing manner and obviously you want to know what the problem is. Autism spectrum disorder can be recognized from some specific behavior.
One of the most important steps in child health monitoring is the evaluation of development. For this reason, in the assessment of child evaluation; the child’s gross motor, fine motor movements, understanding what is said, expressing their wishes, speaking and social communication skills should be evaluated whether they are appropriate for their age.
During the screening, the development process should be evaluated in detail by taking into consideration the observations of the doctor about the child, history and physical examination findings, and the concerns of the family about the development of the child. However, there is no specific screening test in routine use for early detection of autism spectrum disorder.
In some tests, experts and parents can compare the child’s behavior with the typical behavior of children with autism. The result of the test is not diagnostic. On the other hand, thanks to this test, parents can see if there is a reason to do more detailed research.
The attention of families is very important for the diagnosis of autism. Let’s think that there is a family with 12 months old child, there are some points that a family with a child of 12 months should pay attention to. For example, The fact that the child never rips, does not have any hand signals, does not say a single word when the child is 16 months, cannot speak two words spontaneously when he/she comes to 24 months, etc.
When such cases occur, parents can go to an expert in order to ensure the early diagnosis of autism spectrum disorder. Therefore, parents should observe the different behaviors that exist in their children.
Facts About Developmental Screening
- Although it is thought that there are no adequate screening tools for preschoolers, nowadays sound screening measures exist for them. Most of the screening measures have sensitivities. Their specifities are greater than 70%.
- Requirements for training and educatiın are not extensive for screening tools. Paraprofessionals can administer many of them.
- Contrary to popular belief which is screening test takes a lot of time, many tests take less than 15 minutes to complete. And even some of them takes only about 2 minutes to complete.
- Parent’s concerns are predictive of developmental delays. That’s why their concerns are generally valid and essential. According to some researches, parental concerns detect up to 80% of children with disabilities.
Types of Autism Screening Tests
Screening and diagnosis of autism spectrum disorder can be difficult, because there is no medical test, like a blood test, in order to diagnose the disorders. Experts, or at first parents, look at the child’s behavior and development in order to make a diagnosis.
Autism spectrum disorder screening tests are developed based on the symptoms of autism and the characteristics of the child with autism. In the first step, the parents need to have the expert opinion and evaluation as well as the tests they have filled. All behaviors of a child with suspected autism should be observed first.
Screening tests for autism spectrum disorder are indicated as two levels. Level 1 is aimed at identifying those who are at risk for autism in the community, and level 2 is intended to differentiate autism from other developmental disorders in high-risk children.
Autism tests are CHAT (Checklist for Autism in Toddlers), M-CHAT (Modified Checklist for Autism in Toddlers), ESAT (early screening for autistic traits), CSBS DP (Communication and Symbolic Behavior Scales Developmental Profile), PDDST (Pervasive Developmental Disorders Screening Tests-Stage I and II), TIDOS (Three-item Direct Observation Screen), Rapid ABC Test and ASAS (Australian Scale for Asperger’s Syndrome).
Among these, CHAT and its modified form, M-CHAT, are the most frequently used screening tests in the early diagnosis of autism spectrum disorder.
Autism Spectrum Disorder Awareness Test
It is a test that parents should fill in at the beginning of the diagnosis. It means if parents have any suspicion about a child’s condition, they should fill it first. And then, according to the results they can go to the specialists. This test consists of some basic questions that should be answered as yes or not.
This test was created and developed to raise awareness about Autism Spectrum Disorder. It is important for parents if they suspect that their child has autism. After evaluation by experts, necessary guidance and treatments are made.
Rapid ABC Test
While the standard autism spectrum disorder test that has been used so far takes between 2 and 4 hours, a new test developed by Emory University can understand whether small children are in the risk group or not in just 5 minutes.
Autism is one of the biggest nightmares of parents to be. The diagnosis of this disorder, which has been increasing in our lives for the last 15 years, is very easy to diagnose but impossible to treat. Even if a certain level of improvement cannot be achieved with early diagnosis, treatment methods are provided in order to improve the child’s life quality.
Diagnosis before treatment is a very complicated area for parents. There are such cases that parents cannot be sure of the situation. Even experts from time to time may have difficulty in making these diagnoses. The experts of the American Pediatric Academy recommend that all children who are 18 to 24 months old age undergo routine autism screening.
The test, which is a very simple practice, has been implemented for 10,500 families with doubts about the child so far. The hit rate in the diagnostics revealed the reliability of the test which is 75%.
This test, called the rapid ABC test, aims to measure attention, mutual interaction, and communication in infants aged 15 to 17 months. When the 5-minute test is over, the results are loaded into the computer program. Depending on the results achieved by the computer, the baby is referred to a further scan or not. Research shows that this 5-minute test is very effective in the diagnosis.
The 5-minute test consists of 5 parts. The aim is to identify the babies who are in the risk group as early as possible and start the intervention.
- 1. Gesture and body language
- 2. Attention level
- 3. Body language
- 4. Eye contact
- 5. Communication
Early Screening of Autistic Traits (ESAT)
It is the primary autism screening checklist designed for babies 0 to 36 months old. It is based on the obvious early symptoms of autism. It should be filled in by parents or primary care caregivers. If 3 or more items fail, it means the test does not need to be completed.
When the screening test was first created, it consisted of 19 items. However, experts continued to use only the first 14 items. Although the test has been developed to be applied to babies aged 0 to 36 months, the main goal is to perform autism screening for 14 to 15-month-old babies.
This test should be answered by yes or no. If the Parent or primary caregivers of the child answer 3 or more questions as “no” then the child is eligible for continued screening and should take to the experts.
Studies on diagnosis and treatment will surely come to better points, but what concerns parents is what causes this disorder! All known is that autism spectrum disorder comes from the genetics of the mother and father. It is not necessary that parents should have autism for their child has autism.
If there is anxiety, depression, alcoholism, obsession in genetics, they can lead to small genetic mutations and the child may be born with an autism spectrum disorder. In addition to the genetic infrastructure, scientists claim that there are also environmental factors.
Pesticides, viruses, and chemicals that we use in our homes show the negative effects of the baby in the mother’s womb. For example, babies exposed to thalidomide (a substance used to strengthen the immune system), valproate substance, or rubella are at high risk. In addition, researchers have found that insecticides, food containers used at home, and chemicals found in everything from plastics are also effective.
There is a study that suggests that children living close to busy highway areas have a higher risk of autistic birth than those who do not live in such places. In that study, researchers examined 304 children with autism. When they were born, babies who were living close to busy highways revealed that two times more autism was diagnosed. According to these results, researchers believe that air pollution is one of the reasons that triggered autism spectrum disorder.
M-CHAT (Modified Checklist for Autism in Toddlers)
M-CHAT consists of 23 items developed to be directed to the child’s parent or child’s primary caregiver. Each item in the scale is answered as yes or no. The first 9 of these items were taken from CHAT; the remaining items were prepared by those who developed the scale. The second section based on the observation in CHAT was removed. There are 6 critical items related to autism in M-CHAT.
The M-CHAT screening test is the most recent screening test in the literature among level 1 screening tests because it is easy to apply, relatively short duration, can detect autistic findings between 18 months and 3 years of age, can be filled by families, and has higher sensitivity. The reliability value of the M-CHAT test was found to be 0.69 with 23 items. This value is quite reliable. As a result, the MCHAT test in children aged 18-30 months can be used.
In order to determine the definitive diagnosis in autism, the M – CHAT test which is one of the most applied autism tests is applied to children. M – CHAT test is applied to detect symptoms of autism in 18 – 30/36-month-old children. This test, which consists of 23 items in total, lasts 15 to 20 minutes on average.
M – CHAT Test determines whether a child has a suspicion of autism or not. As a result of this test, children who are diagnosed with autism spectrum disorder are started to be educated as soon as possible. This leads to a decrease in autism symptoms with early diagnosis. All children who fail in either of the 23 items included in the scale or any of the critical items of 6 are at risk for autism spectrum disorder.
M – Chat test should be answered by the child’s mother or the child’s primary caregiver. 23 questions asked in the test should be answered by taking into consideration of the general situation of the child. If a certain behavior is very rare, the answer should be answered as if it is not done at all.
After the answers to questions, it is determined whether the child shows signs of autism. This autism test is very important for early diagnosis. At the end of the test, the child who has autism symptoms starts an intensive education at home and at school.
- LOW-RISK: If the total score is between 0 and 2. If the child is less than 24 months of age, the test should be repeated after the second birthday. If there is no risk for autism in screening, no further action is required.
- MID-RISK: If the total score is between 3 and 7. To obtain additional information regarding risk-indicating responses, the observation part of the test should be completed. If the M-CHAT score is again 2 or higher, the child is considered to have autism on screening. Refer the child for diagnostic and early intervention compliance assessments.
If the score is between 0 and 1, the child is considered to be autism negative in the scan. If there is no risk for autism in screening, no further action is required. The child should be re-screened for subsequent child examinations.
- HIGH-RISK: If the total score is between 8 and 20. By skipping the observation part, the child can be referred for diagnostic and early intervention assessment.
TIDOS (Three-item Direct Observation Screen)
The TIDOS scale makes it easier to apply and scans more children as a result of the increasing prevalence of autism spectrum disorder. This scale is based on direct observation of the child. The scale can be applied in clinical practice by health professionals such as physicians, psychologists, psychiatrists, pediatricians, nurses, pedagogues, neurologists.
In TIDOS; common attention (the person’s attention itself, the arrangement between the person and the object in which it interacts), eye contact, and the answer to the name (in four different cases) are evaluated.
This test is based on the social and communicative link between the child and the physician and the child and his / her parents during the examination of the physician. The test is a simple, easy-to-apply, and newly developed screening test that can be applied in any environment, without requiring any material.
The TIDOS observational screening test is based on the observation of the experts during the examination of the child. Before starting the observation, 2-3 toys will be placed in the environment to be evaluated. Experts during the examination observe the child’s behavior in three areas, which are responding to the name, taking part in common consideration, and making eye contact, in approximately 15 minutes.
Responding to name; It is defined as the look of the child when it is called. The child calls by the name while not looking at the practitioner and dealing with something else. No other word is said to the child other than the name of the child. If the child does not respond, this is repeated 4 times.
Common attention; It means to collect the attention of the baby and the adult with a common point. With his/her forefinger, the practitioner points to an object in both the child’s reach and his/her reach that is not accessible and asks the child to look at it. In doing so, the practitioner first looks at the child, then looks at the object, and then again at the child and observes the child’s gaze.
Eye contact; It is defined as the non-verbal communication form that occurs when two people look into each other’s eyes at the same time. Eye contact should be clear, variable, socially-oriented, and repeated several times in different situations. This is evaluated if eye contact is limited, rare, and inappropriate. If the child looks embarrassed and his/her behavior varies, this parameter is evaluated after the child is used to it.
Communication and Symbolic Behavior Scales- Developmental Profile (CSBS-DP)
In the beginning, this test was not developed for testing autism. However, because of the characteristics of autism, experts can use this test for diagnosis. There are two main aims of CSBS-DP. One is the identification of children who are at risk for developing a communication impairment. And the other is monitoring changes in a child’s communication, speech, and symbolic behavior over time.
This is the first step in routine developmental screening for children who are 6 to 24 months old in order to decide whether a communication evaluation is needed or not. It should be filled by the primary caregiver who nurtures the child on a daily basis. It takes about 5 to 10 minutes to complete.
The Communication and Symbolic Behavior Scales Developmental Profile Infant/Toddler Checklist is developed in order to measure some language predictors. These predictors are collected under 3 umbrellas. The first one is communication composite which consists of emotion and use of gaze, use of communication, and use of gestures. The second one is expressive speech composite which consists of the use of sounds and use of words. The third one is a symbolic composite which consists of an understanding of words and the use of objects.
Pervasive Developmental Disorders Screening Tests – Stage I ve II (PDDST)
This test is designed and developed in order to identify children between 12 to 48 months old who may be on the autism spectrum. This test is completed by the child’s parent or the child’s primary caregiver. It consists of a 23-item questionnaire. The test identifies toddlers and young children who may be on the autism spectrum. And as a result, the tests help to identify who should be referred to experts for a more complete evaluation.
ASAS (Australian Scale for Asperger’s Syndrome)
This scale is designed and developed in order to identify behaviors and abilities indicative of Asperger’s Syndrome in children during their primary school years. It is mostly a Likert type scale. It consists of 24 questions, which should be answered from rarely to frequently, and 10 open-ended questions. It takes about 5 to 10 minutes to complete. It should be completed by parents, teachers, or other caregivers who know the child very well.
Autism Supplies And Developments Plastic Visual ASD Behavior Keyring (Picture Communication Symbols)
It is a great helper for children in case of autism. It is created based on their needs. It helps them to learn daily activities, even negative and positive emotions. These cards are very convenient and educational. You and your child on the autism spectrum will be very satisfied with these cards. https://www.amazon.com/Plastic-Behavior-Keyring-Picture-Communication/dp/B00JNUSDWA?ref_=ws_cp_757c5a71922a7de196a7_p_5_i_p
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Goodtimer – Positive Reinforcement Educational Toy, Visual Timer and Chore Chart
With the help of this toy, it is easy to create an environment to encourage your child whether on the autism spectrum or not. It is created by experts’ advice. It is very convenient and helpful. You can easily teach what reinforcement is or what punishment is to your child. It gives you an opportunity to fix your children’s problematic behaviors. https://www.amazon.com/dp/B07ZH9HB8S/ref=sspa_dk_detail_1?psc=1&pd_rd_i=B07ZH9HB8S&pd_rd_w=UTIei&pf_rd_p=7d37a48b-2b1a-4373-8c1a-bdcc5da66be9&pd_rd_wg=Xg0wG&pf_rd_r=229P8NC8SSKSDY9Y4S0K&pd_rd_r=dbec5ce9-a9b1-4fff-aebe-ddeb82699edd&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEyUkJVODJEUUJXRDVDJmVuY3J5cHRlZElkPUEwODg3ODg2M1IxNEFLMTNFVk5CWSZlbmNyeXB0ZWRBZElkPUEwNDQwNjA3M1IwMVJMQjNKVFVEMCZ3aWRnZXROYW1lPXNwX2RldGFpbCZhY3Rpb249Y2xpY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU=