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Review
. 2024 Jan-Dec:15:21501319241263223.
doi: 10.1177/21501319241263223.

Screening for Autism Spectrum Disorder in Young Children: Still Not Enough Evidence

Bogdan Grigore  1 , Jaime Peters  1 , Jessica Williams  1 , Ginny Russell  1 , Paula Coles  2 , Cristina Visintin  2 , Morwenna Rogers  1 , Robert Hayward  3 , Zhivko Zhelev  1 , Stuart Logan  1 , Christopher Hyde  1
Affiliations
Review

Screening for Autism Spectrum Disorder in Young Children: Still Not Enough Evidence

Bogdan Grigore et al. J Prim Care Community Health. 2024 Jan-Dec.

Abstract

Background: Early detection of autism spectrum disorder (ASD) has the potential to significantly reduce the impact of the condition, however previous reviews have found little evidence to support screening programs for ASD in young children.

Methods: We conducted a review with the aim of updating evidence on 3 aspects: (a) diagnostic stability of ASD in young children; (b) accuracy of ASD screening tools in young children; and (c) the benefits of early interventions in screen-detected young children with ASD.

Results: A total of 33 studies were included in our review. Five studies looking at diagnostic stability reported estimates ranging from 71.9% to 100%, however the majority only included a follow-up of 24 months and all studies raised concerns regarding the risk of bias due particularly to lack of blinding, sample size, and patient flow. A total of 25 studies, reported in 26 articles, were identified that reported accuracy data on 11 screening tools. Most of the reports were concerned with versions of M-CHAT, reporting sensitivity estimates from 0.67 to 1.0; however, many of these were deemed to be of high risk of bias due to lack of blinding and follow-up. Four studies reported on early interventions in screen-detected children; however, the majority did not find significant improvements on the relevant outcomes.

Conclusions: Overall, the evidence on screening for ASD in young children captured by this review is not conclusive regarding the 3 aspects of screening in this population. Future studies should attempt to ensure blinded diagnostic assessments, include longer follow-up periods and limit attrition.

Keywords: ASD; autism spectrum disorder; early detection; early intervention; screening.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA diagram of study inclusion. *One paper included in both Q1 and Q3. +One paper included in both Q1 and Q2.
See this image and copyright information in PMC

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