July 18, 2008, Newsletter Issue #100: Formal Screening Tools for Toddlers

Tip of the Week

There is a plethora of formal screening tools used to detect autism in young children. Many of the tests are administered by parents while others are administered by physicians. The parent-administered tests are used to determine if there is a need for further observation, not for a specific diagnosis.

Common parent-centered tests include Child Development Inventories and the Ages and Stages Questionnaire. These tests include a battery of questions that the parents consider.

The questions are answered "yes/no" and are organized in categories and by age. Social questions for a three-year-old would include:

Does the child smile at others?
Does he greet people with "hi" or similar greeting?
Play games with other children?
Initiate play with others?

Gross motor questions would include skills like standing without support and rolling from his back to his tummy independently. Walking, running and jumping are included as well.

Language development would involve asking if the child uses more than 10 words. If he uses words like, "a, an, you" or "the" in short sentences and if he is able to retell a simple story.

The questions will also include possible problems that parents notice.
Is the child clingy?
Does he act immature?
Does he have eating problems?
Is he potty trained?

Self help questions include feeding skills like using spoons, forks and cups independently and grooming skills like dressing independently. Fine motor skills would include turning pages in a book one at a time, holding a crayon properly and transfers objects from one hand to another.

The screening tests focus on motor skills, social interaction, communication and problem-solving skills. Parents determine if their child requires further evaluation after taking these initial screening tests.

Formal screening tools used to detect autism and related pervasive developmental disorders are administered by a physician. In some cases, a child psychologist will have to administer the test.

Two formal screening tools used to detect autism in toddlers are the Checklist for Autism in Toddlers (CHAT) and the Childhood Autism Rating Scale (CARS). There are many other tests available as well.

The Checklist for Autism in Toddlers is designed to measure social interaction, imaginative play, joint attention (the ability to focus on an object in sync with another person) along with communication skills. The M-CHAT is a version of the formal screening tool that is administered by parents of children under 18 months in age.

The Childhood Autism Rating Scale explores five major domains: verbal communication, listening skills, body movement, tolerance for change and relating to others. CARS also uses input from parents and caregivers in the examination as well.

CHAT and CARS are useful in determining if a child has the symptoms of autism and related pervasive developmental disorders but neither of these formal screening tools are used to diagnose autism.

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