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Autism Checklist Ineffective For Majority: Identifies those who already experience better outcome.

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New reports are touting a researched five-minute checklist designed to evaluate for autism - in children that are 1 yr old. A sample of the questions:

  • Do you know when your child is happy and when your child is upset?
  • When you are not paying attention to your child, does he/she try to get your attention?
  • Does your child point to objects?
  • Does your child use sounds or words to get attention or help?
  • Does your child show interested in playing with a variety of objects?

For my moderately to severe autistic daughter (now 18 years old) - years ago, the answers to those questions would have been: yes, yes, yes, yes, yes.

A majority portion of those represented by the autism label do not exhibit signs until after their first year.

The five-minute checklist at one-year well baby visits that was utilized in the study seemed to me, at first look, to be an ineffective tool. It actually identified less autism than if the checklist was not in the scenario. The general population autism incidence is higher. 

So the second look reminds me that if you consider that my daughter would have been considered A OK under the checklist scenario, at one year of age; the check list rightly SHOULD NOT have been able to identify autism to the degree that it is understood to be present in the general population.

The general population numbers that we are always aware of include all subsets of autism...the checklist that is getting such attention is only going to indicate those within one subset; the no loss and no plateau with display of early warning signs.

Data from parental report on 2720 autism affected children found the following:
Regression (n=44%): A loss of previously acquired social, communication or cognitive skills prior to 36 months.
Plateau (n=17%): Display of only mild developmental delays until the child experiences a gradual to abrupt developmental halt that restricts further advancement of skills.
No Loss and No Plateau (n=39%): Di
splay of early warning signs of autism spectrum disorders without loss or plateau. (source)

This study... found children with early developmental warning signs may actually be at lower risk for poor outcomes than children with less delayed early development who experience a loss or plateau in skills.

The above cited study data pointed out that no particular intervention was utilized in order that the no loss and no plateau group experience better outcome than the regression and plateau group. However, the individuals who are developing the five minute checklist have left out the fact that this is the case for the subset that their checklist will identify. NICE. The subset their checklist identifies will probably has greatest potention for having best outcome regardless of intervention.


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