Screening at 1-year checkup may be helpful in diagnosing developmental delays

Pierce K. J Pediatr. 2011; doi:10.1016/j.jpeds.2011.02.036.

The 1-year well-baby checkup may be a good place to start in detecting developmental delays, according to a study published online.

Karen Pierce, PhD, and colleagues of the department of neurosciences at UC San Diego School of Medicine in La Jolla, Calif., examined the results of a study in which 137 pediatricians administered the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist to the parents of nearly 11,000 infants at their 1-year checkup.

The profile checklist takes a few minutes to fill out and covers several areas of behavior, including symbolic behavior, social and emotional communication and expressive speech.

The researchers said 184 infants who failed the screen were followed, and of these, 32 infants “received a provisional or final diagnosis of autism spectrum disorders (ASD), 56 of language delay, nine of developmental delay, and 36 of ‘other.’” The researchers noted that the positive predictive value was estimated to be 75%.

After the screen, all toddlers diagnosed with ASD or developmental delay, and 89% of those with language delay, were referred for behavioral therapy at about 17 months of age. On average, these children began receiving treatment at the age of 19 months.

“There is extensive evidence that early therapy can have a positive impact on the developing brain,” Pierce said in a statement about the study. “The opportunity to diagnose and thus begin treatment for autism around a child’s first birthday has enormous potential to change outcomes for children affected with the disorder.”

The researchers concluded that this approach “shows promise as a simple mechanism to detect cases of ASD, language delay and developmental delay at 1 year” and offers an alternative to the baby sibling design as a mechanism to study autism prospectively.

“Given lack of universal screening of infants for such disorders at 12 months, this program could be adopted by any pediatric office, at virtually no cost, to aid in the identification of children with developmental delays,” Pierce said in the statement. “Importantly, parents will be able to get help for their children at a much earlier age than before.”

Disclosure: The researchers report that this work was funded by the support from the Organization for Autism Research (OAR), Autism Speaks (formerly Cure Autism Now) and a National Institute for Mental Health Autism Center of Excellence grant. The researchers reported no relevant financial disclosures.

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