Practice parameter: Screening and diagnosis of autism

TLDR

Autism affects 1 in 500 children, is frequently undiagnosed until after preschool, and early identification with intensive intervention improves outcomes. This practice parameter reviews empirical evidence and provides specific recommendations for identifying children with autism. The recommended approach involves routine developmental surveillance and autism‑specific screening for all children, followed by diagnostic evaluation to distinguish autism from other developmental disorders.

Abstract

Autism is a common disorder of childhood, affecting 1 in 500 children. Yet, it often remains unrecognized and undiagnosed until or after late preschool age because appropriate tools for routine developmental screening and screening specifically for autism have not been available. Early identification of children with autism and intensive, early intervention during the toddler and preschool years improves outcome for most young children with autism. This practice parameter reviews the available empirical evidence and gives specific recommendations for the identification of children with autism. This approach requires a dual process: 1) routine developmental surveillance and screening specifically for autism to be performed on all children to first identify those at risk for any type of atypical development, and to identify those specifically at risk for autism; and 2) to diagnose and evaluate autism, to differentiate autism from other developmental disorders.