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Screening Tools

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 than “in.”

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 screening tools.

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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.

First Signs 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.

First Signs 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 improvement.

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Screening tools and related information to help clinicians

To assist physicians and other healthcare providers in the screening process, First Signs 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

First Signs 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 First Signs about the efficacy of the screening tools recommended on the First Signs Web site.

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Last update: 01/06/12
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