Locally developed screening tool detects autism at 11 months

A new screening tool, developed by researchers from La Trobe University, helps detect autism in very young children.

Developed over 15 years by Associate Professor Barbaro from the Olga Tennison Autism Research Centre (OTARC), the tool is used to identify a set of behaviours that are characteristic of children on the spectrum from as young as 11 months old, including infrequent or inconsistent use of: gestures, like waving and pointing at objects; response to name being called; eye contact; imitation or copying others’ activities; sharing interest with others; and pretend play.

The development involved a five-year study of over 13,500 Victorian children, with findings published in JAMA Open. The study found the Social Attention and Communication Surveillance–Revised (SACS-R) tool to be “extremely accurate in identifying very young children on the autism spectrum. Of the infants and toddlers aged 12 to 24 months identified at ‘high likelihood’ for an autism diagnosis by the tool, 83% were later diagnosed with autism.”

When used alongside a SACS-Preschool check, 96% of children on the autism spectrum were identified by their 3.5-year health check.

Lead researcher Associate Professor Barbaro said the research points to the critical need for the SACS-R and SACS-Preschool to be rolled out across Australia and the world, as part of regular infant health checks.

“Parents are often told to ‘wait and see’ when raising queries about their child’s development. This means the average age of diagnosis is around four to five, and opportunities for early supports have been missed,” Associate Professor Barbaro said.

“Putting this extremely effective tool in the hands of a trained primary health professional, so that during their routine health checks they are also monitoring for autism, makes a huge difference to early diagnosis.

“Not only is SACS-R the world’s most effective screening tool, unlike many it can be used within the community on large populations, enabling early identification of very young children across the board,” Associate Professor Barbaro claimed.

Professor Barbaro said early diagnosis of autism is critical, as it leads to earlier access to affirming supports and services.

“Early diagnosis improves developmental outcomes, increases participation in schooling, and allows children to understand their needs and identity from a young age,” Professor Barbaro said.

Every Victorian child attending a routine health check at 12, 18 and 24 months is already monitored with the SACS-R tool, after the Victorian Government funded state-wide training for maternal and child health nurses in 2019.

The added SACS-Preschool tool can be used at the 3.5-year health check to increase the effectiveness of the identification process — though training for that is not currently funded in Victoria.

The tool is also being used in Tasmania, and training has been completed in New South Wales, Queensland and South Australia. Health professionals in 10 other countries around the world — including China, Singapore, Poland, Japan, New Zealand, Nepal and Bangladesh — have also been trained in using the tool.

La Trobe Vice-Chancellor Professor John Dewar AO said, “Early autism identification using this tool has already changed the lives of thousands of children and their families around the world.

“An extraordinary contribution by La Trobe’s autism experts, this new research will likely lead to even more countries adopting the tool and embedding screening programs into their health systems.”

The accuracy of autism screening tools used in other parts of the world is very limited, including the well-known M-CHAT, which has an accuracy level of just 6% when used in a community-based population.

The tools were tested using funds from the Autism CRC and Menzies Foundation.

Image credit: ©stock.adobe.com/au/Birute