NEW YORK (Reuters Health) – It’s possible for pediatricians to detect autism spectrum disorders (ASD) and other developmental delays at the 1-year well-baby check-up using a simple screening checklist completed by the parent, a new study suggests.

“This is the first and only study that demonstrates the feasibility of using a broad screen in a medical settings to detect autism as young as 12 months,” the study team notes in the April 29 online issue of The Journal of Pediatrics.

The opportunity to begin treatment for autism early, around the first birthday, has the potential to improve outcome in affected children, Dr. Karen Pierce, of the Autism Center of Excellence, University of California, San Diego and colleagues note in their report.

Practice guidelines from the American Academy of Pediatrics (AAP) recommend screening for ASD at the 18 and 24 month visits, but there is currently no standardized screening approach. In most cases, autism is not diagnosed until age 3 or later.

The Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-IT-Checklist), developed in 2002, detects a wide range of disorders such as global developmental delay, general language delay, and autism, but has never been administered systematically in a clinical setting.

The 24-item CSBS-DP-IT-Checklist, completed by the parent, quantifies the child’s proficiency in three subdomains: social and emotional communication, receptive and expressive speech, and symbolic behavior. It takes about 5 minutes to complete and about 2 minutes to score and is available free online here http://www.brookespublishing.com/store/books/wetherby-csbsdp/index.htm

Dr. Pierce and colleagues report that, over the course of several years, 137 pediatricians in the San Diego area used this tool to screen 10,479 children at the 1-year-old well-baby visit and 1,318 failed the screen.

A total of 184 of these infants were further evaluated and tracked and 32 received a provisional or final diagnosis of ASD; 5 infants originally considered as having ASD no longer met criteria later on. In addition, the screening tool identified 56 infants with LD, 9 with DD, and 36 with “other.”

Dr. Pierce and colleagues estimate that the checklist has a positive predictive value of 75%.

“On the basis of the sample of children who were tracked in this study, our results suggest that approximately 20% of infants who fail the CSBS-DP-IT-Checklist at the 12-month pediatric check-up will manifest an ASD, 55% will manifest an LD, general DD, or associated issue, and 25% will have a false-positive result,” they report.

All of the toddlers with an ASD or DD and 89% of those with LD were referred for behavioral therapy when the delay was detected and they began treatment around age 17 months, on average.

“Any screening program that aims to identify toddlers at risk and thus begin treatment around the first birthday at least offers the opportunity for significant gains to be made,” the researchers note.

For example, a study published recently in Pediatrics found that toddlers with autism who received a developmental behavioral intervention between 18 and 30 months of age had an increase in 15 IQ points following treatment.

The 137 pediatricians who screened infants as part of study are continuing to do so today. According to the UCSD’s Autism Center of Excellence website, over 170 pediatricians are now involved and they have screened over 18,000 toddlers at the routine 12-month well-baby visit.

J Pediatr 2011.