Early Identification of Young Children with ASD and Other Developmental Disabilities: Areas for Improvement

Main Article Content

Elizabeth Crais, Ph.D.


There continues to be an ongoing effort in pediatric practice to improve screening and referral rates of children with potential developmental disabilities including Autism Spectrum Disorder (ASD). Successes have been seen in practices relative to broad developmental screening efforts and increasing improvement in screening for ASD. However, gaps continue to occur in screening, referral for further evaluation, and follow-up that allows the practice (and treating provider) to know the outcome of the referral. This type of “closing the loop” between providers and referral sources is necessary for the practice to function as a medical home for the child and family. In addition, caregivers have highlighted many challenges in the early identification process in working with their primary care provider. This manuscript discusses some of the barriers to early identification for children and their families, successful strategies for more consistent screening and closing the loop following referral, and highlights parental perceptions about identification and referral. Further, practical approaches that could be used by pediatric providers are highlighted.

Article Details

How to Cite
CRAIS, Elizabeth. Early Identification of Young Children with ASD and Other Developmental Disabilities: Areas for Improvement. Medical Research Archives, [S.l.], v. 9, n. 5, may 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2402>. Date accessed: 24 june 2021. doi: https://doi.org/10.18103/mra.v9i5.2402.


1. Lipkin PH, Macias MM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Promoting optimal development: Identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics. 2020;145:e20193449
2. Hyman SL, Levy SE, Myers SM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Executive summary: Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145:e20193448
3. Dawson G, Rogers S, Munson J, Smith M, Winter J, Greenson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics. 2010;125:e17-23
4. Wetherby AM, Guthrie W, Woods J, Schatschneider C, Holland RD, Morgan L, et al. Parent-implemented social intervention for toddlers with autism: An RCT. Pediatrics. 2014;134:1084-1093
5. Lipkin PH, Macias MM, Baer Chen B, Coury D, Gottschlich EA, Hyman SL, et al. Trends in pediatricians’ developmental screening: 2002-2016. Pediatrics. 2020;145:e20190851
6. Arunyanart W, Fenick A, Ukritchon S, Imjaijitt W, Northrup V, Weitzman C. Developmental and autism screening: A survey across six states. Infants & young children. 2012;25:175-187
7. Self TL, Parham DF, Rajagopalan J. Autism spectrum disorder early screening practices: A survey of physicians. Communication disorders quarterly. 2015;36:195-207
8. Carbone PS, Campbell K, Wilkes J, Stoddard GJ, Huynh K, Young PC, et al. Primary care autism screening and later autism diagnosis. Pediatrics. 2020;146:e20192314
9. Monteiro SA, Dempsey J, Berry LN, Voigt RG, Goin-Kochel RP. Screening and referral practices for autism spectrum disorder in primary pediatric care. Pediatrics. 2019;144:e20183326
10. Robins DL, Fein D, Barton M. Modified checklist for autism in toddlers, revised, with follow-up (M-CHAT-R/FTM). https://mchatscreen.com/mchat-rf/. Published 2009.
11. Crais ER, McComish CS, Humphreys BP, Watson LR, Baranek GT, Reznick JS, et al. Pediatric healthcare professionals’ views on autism spectrum disorder screening at 12-18 months. Journal of autism and developmental disorders. 2014;44:2311-2328
12. Kimple KS, Bartelt EA, Wysocki KL, Steiner MJ. Performance of the modified checklist for autism in toddlers in Spanish-speaking patients. Clinical pediatrics. 2014;53:632-638.
13. Kleinman JM, Robins DL, Ventola PE, Pandey J, Boorstein HC, Esser EL, et al. The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of autism and developmental disorders. 2008;38:827-839
14. Guthrie W, Wallis K, Bennett A, Brooks E, Dudley J, Gerdes M, et al. Accuracy of autism screening in a large pediatric network. Pediatrics. 2019;144:e20183963
15. Robins DL. Screening for autism spectrum disorders in primary care settings. Autism. 2008;12:537-556
16. Robins DL, Casagrande K, Barton M, Chen C-MA, Dumont-Mathieu T, Fein D. Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics. 2014;133:37-45
17. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, et al. Prevalence of autism spectrum disorder among children aged 8 years – Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR surveillance summary. 2018;67:1-23
18. Crais E, McComish CS, Kertcher EF, Hooper S, Pretzel R, Mendez L, et al. Autism spectrum disorder identification, diagnosis, and navigation of services: Learning from the voices of caregivers. Focus on autism and other developmental disabilities. 2020;35:246-256
19. Martinez M, Thomas KC, Williams CS, Christian R, Crais E, Pretzel R, et al. Family experiences with the diagnosis of autism spectrum disorder: System barriers and facilitators of efficient diagnosis. Journal of autism and developmental disorders. 2018;48:2368-2378
20. Zuckerman KE, Lindly OJ, Sinche BK. Parental concerns, provider response, and timeliness of autism spectrum disorder diagnosis. The journal of pediatrics. 2015;166:1431-1439.e1
21. Zuckerman KE, Sinche B, Mejia A, Cobian M, Becker T, Nicolaidis C. Latino parents’ perspectives on barriers to autism diagnosis. Academic pediatrics. 2014;14:301-308

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.