Pediatricians, nurse practitioners, and family doctors start screening your baby or toddler for signs of developmental or communication challenges like autism spectrum disorder (ASD) from the very first visit.
As a pediatrician, how your baby responds to you (and to me) during the various visits during infancy and toddlerhood guides me in his screening. In the office I get to observe how your baby giggles, how he looks to his parents for reassurance, how he tries to regain mom’s attention during our conversation, how he points or waves, how he responds to his name, and even how and why he cries when I’m around. Those observations in combination with family history, health examinations, and parental perspectives remain extremely valuable for me in helping identify children at risk for ASD.
Formalized Autism Screening Recommended at the 18- and 24-Month Well-Child Checks:
More formalized screening is recommended at the 18- and 24-month well-child checks.
Modified Checklist for Autism in Toddlers (M-CHAT)
In most offices, clinicians use the Modified Checklist for Autism in Toddlers (M-CHAT), a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening, pediatricians can pick up children at risk for ASD and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a toddler at risk with additional genetic, neurologic, or developmental testing.
Screening Isn’t Diagnosing!
It’s important to note that screening isn’t diagnosing. If your child has a positive screen for an ASD, it doesn’t mean he will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about ASD, don’t be shy. Screening tests are just that—screening—and don’t identify all children with ASD. The rate of success for the M-CHAT, for example, isn’t 100%, so we use it in combination with health and family history to identify children at risk. In my opinion, your opinions as a parent are irreplaceable and of the most importance.
If You Are Concerned and Your Child Has Not Been Formally Screened:
If you are concerned your child has an ASD and your child hasn’t been formally screened, talk with your clinician about doing a formal screening. Many screening tools are available for general doctors.
But know this: if you are concerned about your child’s communication or behavior due to a family history of ASD, the way he talks or expresses himself, or other people’s comments about his behavior, don’t wait to talk with the clinician about doing more. If the first doctor doesn’t respond to you or take you seriously, get a second opinion.