In our efforts to promote early identification of developmental disorders in
young children, First Signs, Inc. has conducted an extensive review of current
screening tools. This section serves as an overview of, and introduction to,
the practice of routine screening by pediatric clinicians.
In this section, you will find information about:
How are screening tools used?
Screening tools are brief measures that differentiate children who are at risk
for atypical development from those who are not. They range from effective questionnaires
given to parents in waiting rooms to brief, but purposeful, give-and-take exchanges
and observations during pediatric exams. Often, screening tools can help eliminate
worries of developmental delays, by screening children “out,” rather
Screening by itself does not provide a diagnosis, but is the first key step in
the diagnostic process. Therefore, it is important for health care providers
to immediately refer those flagged as “at risk” during screening to
diagnostic specialists for more extensive diagnostic evaluation and referral
for appropriate intervention. Please visit our
Screening Process section for
key guidelines about screening, referral, and diagnosis.
Screening tools have applications for physicians, healthcare providers, clinics,
day care center providers, schools, parents, and others who work with young children.
Screening tools are available to identify a variety of concerns from broad-based
developmental disorders to autism spectrum disorders to other related disorders,
such as attention deficit disorder and bipolar disorder.
Our current focus is developmental and autism spectrum disorders. Please revisit
this Web section in the future as we expand our list of disorders and related
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Screening recommended at every well visit
In recent years, leading medical organizations have issued a number of policy
statements that provide guidelines for the screening and diagnosis of autism
spectrum disorders and call for routine developmental screening in young children.
In keeping with these statements, First Signs
recommends that a physician or
trained nurse practitioner perform a routine developmental screening at every
well visit starting at four months of age.
recommends that physicians conduct developmental screening at every
well child visit (minimally, at all well visits between 12 and 36-months) for
any type of atypical development. If the developmental screening indicates a
concern, a simple autism screening should be performed, along with a formal audiological
assessment, a lead screen for pica, and a referral to Early Intervention and to
a specialist for a developmental evaluation. If
the autism screening flags a potential problem, the child should be should be
referred to a specialist for formal diagnostic testing. For older verbal children
(ages 4 and older), an Asperger Syndrome screen may be appropriate with referral
to a diagnostic specialist.
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Why are screening tools important?
Screening tools encourage routine and systematic surveillance of developmental
milestones and concerns. Many high quality screening tools rely upon parent report,
which has been proven to increase screening tool accuracy. They stimulate dialogue
between practitioners and parents about the more subtle aspects of development—social, emotional,
and communication. Looking more carefully and
qualitatively at developmental milestones allows parents’ concerns to be addressed
in a timely manner and improves outcomes for all children, not just those challenged
by autism and developmental disorders.
recommends “sensitive” screening tools over screening tools
with high “specificity” (those proven to identify children at risk
vs. those that screen out children who are not at risk), since the prevalence
of children with autism spectrum and other childhood disorders is dramatically
on the rise. By identifying as many children as possible as early as possible,
effective interventions can begin immediately. Only with consistent and intensive
intervention, will children with autism and related disorders experience real
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Screening tools and related information to help clinicians
To assist physicians and other healthcare providers in the screening process,
has provided information and ratings on several validated screening
tools that are brief, accurate, and cost-effective. The
Screening Tools section
gives physicians and other healthcare providers access to information about the
best screening tools currently available.
Furthermore, we have developed the
First Signs Screening Kit, which includes
several highly validated screening tools, screening guidelines, an educational video,
a developmental milestones wall chart, and an Early Intervention referral guide.
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The future of screening in early childhood
will follow the introduction of newer and more improved screening
tools as they are developed, field tested, and normed on large populations of
children in years to come. Our recommended screening tools will keep in step
with such changes so that we always offer physicians, professionals, and parents
the most current information on screening tools available.
With proper funding, First Signs
can help screening tool researchers reach a
wider geographic and demographic base of participants for their studies in the
future as well. We encourage clinicians to provide feedback to
the efficacy of the screening tools recommended on the First Signs
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