As with many diseases, early intervention is often the key to successful treatment of autism. Unfortunately, it is difficult to detect the disorder in very young children using existing diagnostic instruments.

Now, researchers from the psychology department have introduced a screening device they hope will accurately identify children under the age of three who have autism. In a recent pilot study, the device detected autism in 22 young children.

Autism is a developmental disability that typically appears during the first three years of life and is disruptive to social relationships, communication and imaginative play.

"In order to begin the intervention before age three, we need to have a good way to identify these children at this very young age," says Diana Robins, a doctoral student in psychology. "This is where the research Deborah Fein, Marianne Barton and I are doing comes in."

Robins; Fein, a psychology professor; and Barton, a visiting assistant professor of psychology and director of the psychological services clinic, designed the Modified Checklist for Autism in Toddlers, or M-CHAT, to alert healthcare practitioners to possible cases of autism in children between 18 and 24 months of age. The screening device is an extension of the Checklist for Autism in Toddlers, or CHAT, a British screening measure.

To create the device, Robins, Fein and Barton took the first nine items from the CHAT. They created an additional 21 items by generating a list of symptoms thought to be present in very young children with autism. These items were created based on hypotheses in the literature, clinical instruments used to evaluate older children, the researchers' own clinical experiences, and findings gleaned from home videos of children later found to have autism.

In a pilot study, more than 600 children were screened using the M-CHAT, which their parents were asked to complete. Once a child failed three or more items thought to be critical to autism at 18 to 24 months, the family was called and responses confirmed over the telephone. If the child's score still indicated symptoms of autism, the family was invited to participate in a free developmental evaluation. Following the evaluation, children were diagnosed as being on the autism spectrum; classified as displaying autistic behaviors but not meeting criteria for an autism spectrum disorder; or were found to have delays unrelated to autism. No child evaluated was found to have typical development.

Of the 607 children screened, 569 did not require follow-up. Of the remaining 38 children, 10 didn't require an evaluation because telephone follow-up indicated they didn't show significant symptoms of autism. Six children were evaluated and found to have language or global delays, not autism. The remaining 22 children were diagnosed with an autism spectrum disorder. All evaluated children were referred for appropriate treatment.

Recent autism research has shown that early intervention leads to optimal prognosis, Robins says. Children who begin to receive aggressive early intervention before the age of three are more likely to be able to attend school with typically developing children and have fewer long-term deficit.

By developing an instrument that can accurately detect autism in young children, Robins, Fein and Barton have given healthcare providers the means to begin the early intervention that can be critical to children with autism and their families. They are continuing to recruit pediatricians and family practice doctors to use the instrument.

This research is supported by the University's Research Foundation and the U.S. Department of Education. The researchers have also applied for support from the National Institutes of Health. Their findings were presented at the 1999 annual meetings of the American Psychological Association and the Connecticut Psychological Association.

Allison Thompson