Autism screening involves looking at a child’s development to see if their skills are progressing as expected for their age. Differences in their behavior, speech, and movement may be signs a child is autistic.

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Every child develops uniquely. Even so, parents, healthcare professionals, and early childhood educators can keep an eye on a child’s development to ensure they build certain skills and abilities as they grow.

The process of watching the way a child builds skills and abilities is often called developmental monitoring. It can be informal, or the people in a child’s life may use tools such as a checklist to track when a child reaches each milestone.

When it comes to autism, early identification and treatment can make all the difference in a child’s life. That’s why autism screening is so important.

According to the Centers for Disease Control and Prevention (CDC), health professionals can detect autism in children as young as 18 months old, and by 2 years old, an autism diagnosis from a qualified professional may be reliable.

The American Academy of Pediatricians (AAP) recommends that healthcare professionals check a child’s development at 9 months, 18 months, and 30 months. Part of these developmental checks is the opportunity for an autism screening.

Developmental milestone

A developmental milestone is a behavior or skill many children learn by a certain age.

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Autism screening is a more formal process of looking at aspects of a child’s development to detect early potential signs of autism.

In autism screening, a parent or caregiver usually answers questions about how a child moves, plays, speaks, and interacts with others.

Autism screening can happen at a well-child health visit or when a parent, caregiver, educator, or health professional feels concerned.

The AAP recommends autism screening at 18 months and 24 months. If screening shows there are delays in important milestones, caregivers may decide to watch and wait, or they may decide to take a closer look with a full autism evaluation.

Psychologist Marilyn Monteiro, PhD, is the author of the autism diagnostic interview assessment “MIGDAS-2: Monteiro Interview Guidelines for Diagnosing the Autism Spectrum.” Monteiro says an autism evaluation should focus on helping parents and caregivers understand a “child’s pattern of strengths as well as differences.”

“Identifying your child’s strengths provides clues for how to approach their challenging differences in development,” she says.

When health professionals identify autism early in a child’s life, therapies and interventions can make a huge difference in their overall well-being and success.

Inequities in the diagnosis of autism

The Autism and Developmental Disabilities Monitoring Network shared 2020 data on the CDC’s website. It showed that racial disparities in autism diagnosis may be changing for the better in some places.

People must address ongoing racial disparities to ensure every autistic child has the best possible outcomes, and every child needs better access to healthcare, education to reduce the stigma around autism, and fewer language barriers for English learners.

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Autism screening usually involves checklists or questionnaires completed by a parent, caregiver, educator, or healthcare professional with first-hand knowledge of a child’s daily life.

Here’s a look at some of the most commonly used tools used to screen for autism:

Developmental checklists

The CDC offers online checklists and a Milestone Tracker App to help parents and caregivers monitor their children’s development. Parents and caregivers can also learn about milestones from videos in English, Spanish, and American Sign Language.

Ages and Stages Questionnaires

The Ages and Stages Questionnaires (ASQ) ask about a child’s general development, including how they:

  • communicate
  • interact with other people
  • physically move
  • solve problems

Parents or caregivers can usually answer the ASQ questions in 10–15 minutes, and the test is available in many languages.

Modified Checklist for Autism in Toddlers-Revised with Follow-Up

This checklist can help assess children 16–30 months old. The Modified Checklist for Autism in Toddlers-Revised with Follow-Up asks parents 20 questions about how a child usually behaves. It takes about 5 minutes to complete.

If the questionnaire shows that a child has a medium or high chance of developing autism, a health professional may ask follow-up questions to learn more about a child’s skills and abilities.

Screening Tool for Autism in Toddlers and Young Children

The Screening Tool for Autism in Toddlers and Young Children (STAT) can usually help evaluate children 24–36 months old. The STAT is interactive. People trained in working with toddlers and young children interact with children in 12 different activities that show how the child communicates, imitates, and plays.

Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist

The Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist may typically help professionals assess infants as young as 6–24 months old. It has 24 questions, and parents or caregivers complete it. A trained health professional or early intervention specialist scores it.

The infant-toddler checklist takes 5–10 minutes, and people can complete the caregiver questions in 15–25 minutes.

Social Communication Questionnaire

The Social Communication Questionnaire (SCQ) may help evaluate children of 4 years or older. It asks 40 yes-no questions about how a child communicates and interacts with others and takes about 10 minutes to complete.

After a parent or caregiver answers questions, health, developmental, psychological, or education professionals can score the SCQ. Questionnaires are available in many languages.

According to the CDC, in a complete autism evaluation, health professionals look for the autism criteria set by the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5). They include:

  • deficits in social communication
  • deficits in social interaction
  • restricted and/or repetitive behaviors, interests, or activities

For experts to identify autism, these behaviors and patterns must occur in many different settings in a child’s life. They must also be long lasting.

If a child shows signs of autism on an autism screening, the next step is a diagnostic evaluation also called autism testing.

Since early treatment is essential for young autistic children, it’s important to find healthcare and educational professionals with experience in autism testing as soon as possible so your child can begin early intervention services immediately.

These services may help young children before they start school. Research cited by the National Institutes of Health suggests that early intervention services can positively affect an autistic individual for the rest of their life.

Here are a few resources to help you find autism professionals in your community:

Tips for parents navigating the autism diagnosis and treatment process

Your child is more than a diagnosis. Monteiro offers these strategies for navigating the diagnostic process and finding professionals:

  1. Find experienced help: Find a doctor experienced in autism interventions who sees your child as a unique person with strengths and differences and uses strengths-based language.
  2. Focus on strengths and differences (not deficits): When interacting with your child, think — and talk — about strengths and differences, not deficits. The words we use make a difference. If your child focuses intently on a topic or object instead of looking at it through the lens of “restrictive” and “repetitive” behavior, pay attention to how your child uses routines to organize and regulate their brain. For example, a child with a passionate interest in Legos is using their visual, 3D, and strategic thinking skills while taking a break from the hard work of managing incoming language and social demands.
  3. You are the expert on your child: Find a doctor who listens carefully to your unique story and encourages you to tell details about daily life with your child. The diagnostic journey is a partnership, and you are an important part of that process.
  4. Take some time to process an autism diagnosis: Ifthe evaluation results in an autism diagnosis, give yourself time to absorb the information. Find your own story and help each other focus on appreciating the unique brain style strengths and differences in all family members. This solves the puzzle of how family members with diverse worldviews can fit together.
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The benefit of early autism screening is that it can enable you to find services and interventions for your child as soon as possible. Early, evidence-based support can make a world of difference to your child’s — and your family’s long-term well-being.

Can a screening tool identify autism?

Screening tools don’t identify autism on their own. Instead, they show that there may be a need for a deeper evaluation.

Can anyone use an autism screening tool?

It depends on the tool. Lots of developmental checklists are available for parents and caregivers to track a child’s growth. Some questionnaires may rely on information that caregivers provide, but education or health professionals need to score them.

Should I worry if an autism-related skill is delayed?

Every child develops at their own rate. Even so, some delays may indicate autism, and it’s a good idea for professionals to evaluate those. If you’re concerned that behavior such as smiling or imitating others hasn’t developed on time, you can share your concern with a health professional. You can also ask for an autism screening.

Can adults be screened for autism?

Yes. While experts can often identify autism during a person’s childhood, it’s not uncommon for them to identify autism when people are teens or adults.

Autism screening is the process of checking a person’s behavior and speech for characteristics of autism.

Screening often occurs during childhood, but it happens later in life for some people. In autism screening, parents or caregivers usually complete checklists or questionnaires about how a child plays, speaks, moves, and interacts with others.

Based on the screening results, a full autism evaluation could be the next step.