Clinical impact of early diagnosis of autism on the prognosis and parent–child relationships

Figures & data

Table 1 Examples of commonly used ASD screening and diagnostic instruments

Instrument	Use	Training/special certification required to administer?	Administration method
Ages and Stages Questionnaire-Third edition (ASQ-3)^Citation41	Screening	No	Parent report
Modified Checklist for Autism in Toddlers-Revised Follow-up (M-CHAT-R/F)^Citation42,Citation43	Screening	No	Parent report
Screening Tool for Autism in Toddlers and Young Children (STAT)^Citation44	Screening	Yes	Provider interactive
Social Communication Questionnaire (SCQ)^Citation45	Screening	No	Parent report
Autism Diagnostic Observation Schedule-Second Edition (ADOS-2)^Citation46	Diagnosis	Yes	Certified provider interactive observation
Autism Diagnosis Interview-Revised (ADI-R)^Citation47	Diagnosis	Yes	Structured interview of parents
Childhood Autism Rating Scale-Second Edition (CARS-2)^Citation48	Diagnosis	No	Clinician rating
Gilliam Autism Rating Scale–Third Edition (GARS-3)^Citation49	Diagnosis	No	Teachers and clinicians

Abbreviation: ASD, autism spectrum disorder.

Table 2 Skills and behaviors targeted in early intervention and childhood ASD therapies

Skill/behavior	Examples of skill deficit in ASD	Examples* of interventions used to address the targeted skill/behavior	Examples# of intervention evidence
Development: communication	Difficulties in: orienting and attending to social partners; sharing others’ emotional states; directing others to share experiences; using objects in symbolic play; learning shared meanings	• Joint attention interventions • Speech & language therapies • Teaching communication skills • Communication assistive technologies	• Socially synchronous engagement; Landa et al^Citation7 • Joint attention; Murza et al^Citation72 • Picture exchange communication system; Howlin et al^Citation73
Development: social	Difficulties with social relationships	• Social interaction therapies between child and parent, adult, another child • DIR Floortime • Hanen Program – “More than Words”	• Early Social Interaction Project; Wetherby and Woods^Citation8 • More than Words; Carter et al^Citation6
Development: sensorimotor	Difficulties related to over or under-responding to sensations such as sound, touch, smell, taste, sight. Difficulties with: balance, coordination, physical imitation, and low muscle tone	• Sensory therapies – vision, auditory integration, sensory integration • Occupational and physical therapies	• Sensory intervention; Schaaf et al^Citation74 • Motor skills; Srinivasan et al^Citation75
Development: cognitive	Difficulties in: learning; information processing; acquiring skills	• Instructional/educational strategies and settings • TEACCH program	• TEACCH method; Virues-Ortega et al^Citation76
Adaptive behaviors	Difficulties with performing daily activities in a socially responsible way such as eating a meal at mealtime in a way that is participatory of sharing the meal and not disruptive	• Toilet training • Dressing, bathing and mealtime training	• Mealtime behaviors; Johnson et al^Citation77
Problem behaviors	Difficulties in self-managing behaviors which involve tantrums, self-injury, physical aggression, destruction of objects or property	• Applied behavioral analysis-based therapies • Comprehensive treatment programs • Early intensive interventions • Communication training	• Early intensive; Warren et al^Citation78 • Early Start Denver Model; Dawson et al^Citation28 • LEAP Model; Strain and Bovey^Citation79

Notes:

* Interventions included can be used to address the behavior/skill indicated, but may also be used to address the development and/or shaping of other behaviors/skills.

# Studies included are examples of existing evidence and are not indicative of the strength of the evidence.

Abbreviations: ASD, autism spectrum disorder; LEAP, Learning Experiences and Alternative Program for Preschoolers and their Parents.

SquiresJBrickerDPotterLAges and Stages Questionnaires (ASQ-3)3rd edBaltimore, MDPaul H. Brookes Publishing2009

 Google Scholar

RobinsDLFeinDBartonMLGreenJAThe Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disordersJ Autism Dev Disord200131213114411450812

 PubMed Web of Science ®Google Scholar

RobinsDLCasagrandeKBartonMChenCMDumont-MathieuTFeinDValidation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F)Pediatrics20141331374524366990

 PubMed Web of Science ®Google Scholar

StoneWLCoonrodEEOusleyOYBrief report: screening tool for autism in two-year-olds (STAT): development and preliminary dataJ Autism Dev Disord200030660761211261472

 PubMed Web of Science ®Google Scholar

RutterMBaileyALordCBerumentSKSocial Communication QuestionnaireLos Angeles, CAWestern Psychological Association2003

 Google Scholar

LordCRutterMDiLavorePCRisiSGothamKBishopSAutism Diagnostic Schedule2nd edTorrance, CAWestern Psychological Services2010

 Google Scholar

RutterMLe CouteurALordCAutism Diagnostic Interview–Revised (ADI–R) ManualLos Angeles, CAWestern Psychological Services2003

 Google Scholar

SchoplerEVan BourgondienMEWellmanGJLoveSRChildhood Autism Rating Scale2nd edLos Angeles, CAWestern Psychological Services2010

 Google Scholar

GilliamJEGilliam Autism Rating Scale3rd edAustin, TXPro-Ed2014

 Google Scholar

LandaRJHolmanKCO’NeillAHStuartEAIntervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trialJ Child Psychol Psychiatry2011521132121126245

 PubMed Web of Science ®Google Scholar

MurzaKASchwartzJBHahs-VaughnDLNyeCJoint attention interventions for children with autism spectrum disorder: a systematic review and meta-analysisInt J Lang Commun Disord201651323625126952136

 PubMed Web of Science ®Google Scholar

HowlinPGordonRKPascoGWadeACharmanTThe effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomised controlled trialJ Child Psychol Psychiatry200748547348117501728

 PubMed Web of Science ®Google Scholar

WetherbyAMWoodsJJEarly social interaction project for children with autism spectrum disorders beginning in the second year of lifeTopics Early Child Spec Educ20062626782

 Web of Science ®Google Scholar

CarterASMessingerDSStoneWLCelimliSNahmiasASYoderPA randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptomsJ Child Psychol Psychiatry201152774175221418212

 PubMed Web of Science ®Google Scholar

SchaafRCBenevidesTMaillouxZAn intervention for sensory difficulties in children with autism: a randomized trialJ Autism Dev Disord20144471493150624214165

 PubMed Web of Science ®Google Scholar

SrinivasanSMKaurMParkIKGiffordTDMarshKLBhatANThe effects of rhythm and robotic interventions on the imitation/praxis, interpersonal synchrony, and motor performance of children with autism spectrum disorder (ASD): a pilot randomized controlled trialAutism Res Treat2015201573651626793394

 PubMedGoogle Scholar

Virues-OrtegaJJulioFMPastor-BarriusoRThe TEACCH program for children and adults with autism: a meta-analysis of intervention studiesClin Psychol Rev201333894095323988454

 PubMed Web of Science ®Google Scholar

JohnsonCRFoldesEDeMandABrooksMMBehavioral parent training to address feeding problems in children with autism spectrum disorder: a pilot trialJ Dev Phys Disabil2015275591607

 Web of Science ®Google Scholar

WarrenZMcPheetersMLSatheNFoss-FeigJHGlasserAVeenstra-VanderweeleJA systematic review of early intensive intervention for autism spectrum disordersPediatrics20111275e1303e131121464190

 PubMed Web of Science ®Google Scholar

DawsonGRogersSMunsonJRandomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver ModelPediatrics20101251e17e2319948568

 PubMed Web of Science ®Google Scholar

StrainPSBoveyEHRandomized, controlled trial of the LEAP model of early intervention for young children with autism spectrum disordersTopics Early Child Spec Educ2011313133154

 Web of Science ®Google Scholar