Why Screen?
Standardized developmental screening and standardized autism screening (M-CHAT) are two of the most important things a health care provider can do for young children and their families.
Providers are in a unique position to assess very young children because they are one of the few professionals who see them between the critical ages of 0-3 years old.
Standardized developmental screening is important because:
- It supports meaningful conversations between parents and caregivers or health professionals.
- It leads to further assessment and then necessary intervention during the critical early years.
- It promotes early identification and referral to the appropriate resources saves money that would be spent on services later in life.
Standardized autism screening is important because:
- It asks parents directly about the specific symptoms of an Autism Spectrum Disorder (ASD).
- It promotes and furthers earlier identification and diagnosis of an ASD in affected children and thus allows for early intervention specifically directed to the ASD.
AAP Policy Statement – Standardized Developmental Screening - 3 by 3 is a Best Practice
In 2006, the American Academy of Pediatrics revised their policy statement on developmental screening:
- Developmental surveillance should be a component of every preventive care visit. Standardized developmental screening tools should be used when such surveillance identifies concerns about a child’s development and for children who appear to be at low risk of a developmental disorder at the 9-, 18-, and 30-month* visits.
- It is important for physicians to establish working relationships with state and local programs, services, and resources.
- A quality-improvement model can be used to integrate surveillance and screening into office procedures and to monitor their effectiveness and outcomes.
*Note: Because the 30-month visit is not yet a part of the preventive care system and is often not reimbursable by third-party payers at this time, developmental screening can be performed at 24 months of age. In addition, because of the frequency of regular pediatric visits decreases after 24 months of age, a pediatrician who expects that his or her patients will have difficulty attending a 30-month visit should conduct screening during the 24-month visit.
Click here to download the full AAP 2006 Revised Policy Statement.
AAP Policy Statement – Standardized Autism Screening - 2 by 2 is a Best Practice
In 2007, The American Academy of Pediatrics issued a policy statement recommending that all children be screened for Autism Spectrum Disorders at the 18 and 24/30 month well child visits.
Since many children do not come in for a well visit at 18 or 24 months the recommendation could also be thought of as two screens by two years old.
Colorado Statistics
Early Intervention Colorado:
- Program serves eligible infants and toddlers birth through two years of age.
- In 2009, Colorado’s identification rate of infants and toddlers birth to three with IFSP is 2.35%
- Target data for FFY 2010 is to serve 2.5% of Colorado’s birth through two population.
- Early Intervention Colorado has specific guidelines on their website regarding early intervention for children with an Autism Spectrum disorder.
Prevalence and Risk:
- About 16% of children have disabilities including speech and language delays, mental retardation, learning disabilities and emotional/behavioral problems.
- Only 30% are detected prior to school entrance.
- The prevalence of autism is currently thought to be approximately 1/110 children.
Detection Rates with Screening Tests:
- 70% - 80% of children with developmental disabilities correctly identified.
- 80% - 90% of children with mental health problems correctly identified.
- Most over-referrals on standardized screens are children with below-average developmental and psychological risk factors.
- The sensitivity and specificity of the M-CHAT are .85 (sensitivity) and .93 (specificity).
