Autism Spectrum Disorder Detected through Early and Repeated
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A Study was conducted to evaluate timing and accuracy of early and repeated screening for autism spectrum disorder (ASD) during well-child visits.

Using a longitudinal study design, toddlers (n=5784) were initially screened at 12 (n=1504), 15 (n=1228), or 18 (n=3052) months during well-child visits, and rescreened at 18, 24, and 36 months. Of those screened, 368 toddlers attended an ASD evaluation after a positive screen and/or a provider concern for ASD at any visit.

Results:
--Screens initiated at 12 months yielded an ASD diagnosis significantly earlier than at 15 months and 18 months.

--Cross-group overall sensitivity of the initial screen was .715 and specificity was .959.

--Repeat screening improves sensitivity (82.1%), without notably decreasing specificity (all more than 93.5%).

--Screening at 18 months resulted in significantly higher positive predictive value (PPV) than at 12 months (X 2 (1, n=221) = 9.87) and 15 months (X 2 (1, n=208) = 14.57).

--With repeat screening, PPV increased for all screen groups but the increase was not significant.

In conclusion, screening children as young as 12 months old successfully identifies many children at risk for ASD. Children who are screened at 12 months receive an ASD diagnosis much faster than their peers who are screened later in life, allowing for early intervention. However, since the sensitivity of a single screen is limited, screening must be repeated.

Source: https://www.jpeds.com/article/S0022-3476(21)00221-3/fulltext?rss=yes
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