Autism-Early Childhood (through adulthood) screening and identification resources

I  was asked to be part of a team that was developing a culturally responsive Autism screener to be used in Ethiopia a year or two back. The project fizzled with COVID-19, but I did find many resources that can be used to screen youngsters for Autism, with an eye on cultural responsiveness.  Below is a summary of what I found, along with the old standards in Autism Diagnostic assessment tools. Enjoy!

Interviews

The Routines-Based Interview (RBI) is a semi-structured clinical interview designed to help families decide on outcomes/goals for their individualized plans, to provide a rich and thick description of child and family functioning, and to establish an immediately positive relationship between the family and the professional. Ideally, interviewers are trained to conduct the RBI. On the other hand, with the use of this protocol, a professional who is knowledgeable about child development, knowledgeable about child and family functioning, and who has good interview skills should be able to conduct a successful RBI. Useful at all ages, but especially 0-5 years. (FREE) 

Uses domains of YCDD: Physical, Cognitive, Communication. Social/ Emotional,  Adaptive. Routine Based Interview form can be found at: https://blogs.illinois.edu/files/6150/364271/88801.pdf  Directions/ Routine Based Interview Protocol be found at: https://inclusioninstitute.fpg.unc.edu/sites/inclusioninstitute.fpg.unc.edu/files/handouts/McWilliam%20-%20Protocol%20for%20RBI.pdf

Screeners

Modified Checklist for Autism in Toddlers (M-CHAT-R/F)  https://mchatscreen.com The M-CHAT-R can be administered and scored as part of a well-child care visit, and also can be used by specialists or other professionals to assess risk for ASD. The primary goal of the M-CHAT-R is to maximize sensitivity, meaning to detect as many cases of ASD as possible. Therefore, there is a high false-positive rate, meaning that not all children who score at risk will be diagnosed with ASD. To address this, we have developed the Follow-Up questions (M-CHAT-R/F). Users should be aware that even with the Follow-Up, a significant number of the children who screen positive on the M-CHAT-R will not be diagnosed with ASD; however, these children are at high risk for other developmental disorders or delays, and therefore, evaluation is warranted for any child who screens positive. The M-CHAT-R can be scored in less than two minutes. Scoring instructions can be downloaded from http://www.mchatscreen.com. Associated documents will be available for download as well.http://www.mchatscreen.com. Available in 46 languages. How cool is that! (Ages 16-30 months). (FREE) 

Ages and Stages Questionaire-3 (ASQ-3) https://agesandstages.com/about-asq/

ASQ-3 is not an autism screener. However, ASQ-3 reliably picks up delays associated with autism and identifies children who should receive further evaluation. Questions on behavior and communication in the Overall section also elicit parent concerns that may point to autism. Children with autism were included in the normative sample for ASQ-3. (Ages birth-6 years)

Pervasive Developmental Disorders Screening Test-II (PDDST-II)  https://www.med.uvm.edu/vtlend/pddstii. The PDDST-II is a parental-report Autism screening tool developed to serve as a practical piece of early childhood developmental screenings. There are three different varieties of forms, depending on the screening setting, which take less than 15 minutes to complete and less than 5 minutes to score. (Ages 12-48 mos)

Progress Monitoring

Autism Treatment Evaluation Checklist (ATEC)  https://www.autism.org/autism-treatment-evaluation-checklist/  The ATEC is a one-page form designed to be completed by parents, teachers, or caretakers. It consists of 4 subtests: I. Speech/Language Communication (14 items); II. Sociability (20 items); III. Sensory/ Cognitive Awareness (18 items); and IV. Health/Physical/Behavior (25 items).  The ATEC is not a diagnostic checklist. It basically provides several subscale scores as well as a total score to be used for comparison at a later date. Basically, the lower the score, the fewer the problems. Available in 26 languages! (Ages 2+)

Diagnostic Rating Scales

GARS (Ages 3- 22)  The Gilliam Autism Rating Scale, Third Edition (GARS-3) 

• clinicians identify autism, assess its severity, and determine the appropriate intervention. 
• Items in the third edition of this widely used test reflect criteria for diagnosing Autism Spectrum Disorder (ASD) found in the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

ASRS (Ages 2-18)  The Autism Spectrum Rating Scales (ASRS™) provides the first nationally standardized, norm-referenced ASD Rating Scale. This multi-informant measure helps identify symptoms, behaviors, and associated features of Autism Spectrum Disorders (ASDs) in children and adolescents. 

Diagnostic Assessments

Autism Diagnostic Interview-Revised (ADIR) https://www.wpspublish.com/adi-r-autism-diagnostic-interviewrevised (Ages: mental age above 2.0 years) 

• Useful for diagnosing autism, planning treatment, and distinguishing autism from other developmental disorders. 
• Along with the ADOS-2 considered to be the "Gold Standard" in identifying Autism Spectrum Disorders. 
• Available in 17 languages!  including English, Danish, French,  Hungarian, Japanese, Russian & Spanish.
• Provides categorical results for three domains: Language/Communication, Reciprocal Social Interactions, and Repetitive Behaviors/Interests.  
• Standardized interview and response coding, Administration time: 90-150 minutes, including scoring

Autism Diagnostic Observation Schedule- Second Edition (ADOS-2) https://www.wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition Age range: 1 year and up)   Administration time: 40 to 60 minutes.

The ADOS-2 accurately assesses and diagnoses autism spectrum disorders across age, developmental level, and language skills.

The ADOS-2 is a semi-structured, standardized assessment of:

• Communication
• Social interaction
• Play
• Restricted and repetitive behaviors

The assessment presents various activities that elicit behaviors directly related to a diagnosis of ASD.  By observing and coding these behaviors, you can obtain information that informs diagnosis, treatment planning, and educational placement.

Childhood Autism Ratings Scale, Second Edition (CARS-2) https://www.wpspublish.com/cars-2-childhood-autism-rating-scale-second-edition (Ages 2 and up)

• Helps to identify children with autism and determine symptom severity through quantifiable ratings based on direct observation. Also available in Bulgarian and Italian
• Cutoff scores, standard scores, and percentiles
• Two 15-item rating scales completed by the clinician (each designed for a different population, based on level of cognitive functioning); and an unscored parent/caregiver questionnaire.
• Administration time: 10 minutes (after the information needed to make the ratings has been conducted [which can be lengthy])

Communication and Symbolic Behavior Scales (CSBS)  https://brookespublishing.com/product/csbs/  

• CSBS consists of 22 communication and symbolic rating scales grouped into seven “clusters”: communicative functions, gestural communicative means, vocal communicative means, verbal communicative means, reciprocity, social-affective signaling, and symbolic behavior. 
• AGE RANGE  CSBS is used with infants and toddlers whose functional communication age is between 6 and 24 months and for children up to 72 months who exhibit atypical development. 
• COMPLETED BY  Caregivers and professionals trained to assess young children (e.g., speech-language pathologists, early interventionists, or psychologists); professionals score.  
• TIME COMMITMENT  Approximately 50–75 minutes for child assessment; 60–75 minutes for in-depth scoring