The multi-step screening process started with parents completing two questionnaires: one about their child’s emotional behavior and one about their child’s social behavior. Based on the responses, some children were selected to be observed in person by experts who analyzed their behaviors. These same experts then gave a final evaluation and a diagnosis if appropriate.
“When implemented with appropriate supports and access to diagnostic services, screening can really move the needle on the early detection of autism,” said researcher Dr. Radley Chris Sheldrick. “If implemented in a culturally sensitive way, it can also reduce health disparities in autism diagnoses, which have been well-documented in literature.”
Language and gender played a role
For the study, the researchers analyzed records from over 33,300 children between the ages of 14 and 26 months who were enrolled in early intervention (EI) services in the Boston area from 2012 through 2018. The data was pulled from a dozen different EI sites; nine of the locations weren’t screening for autism, while three of the locations had adopted the in-depth screening process.
Although the screening process required more steps, the researchers learned that it was effective at identifying children with autism. The multi-step screener was linked with more than 8 additional autism diagnoses per 1,000 children; that figure jumped to more than 15 additional diagnoses per 1,000 children for Spanish-speaking families.
The study showed that young boys were more likely than young girls to be diagnosed with autism with these new screening efforts. Nearly 15 more boys were diagnosed after this process, compared with 0.5 more girls.
The researchers hope this work emphasizes how important it is for EI providers to be diligent about this process, as it can make significant long-term changes for families.
“We did not anticipate this finding, and we believe it highlights the importance of monitoring all points in the care process – whether or not disparities are expected,” Dr. Sheldrick said. “Further research is needed to ensure equitable access to effective services for those who need them.”