Developmental surveillance for autism

The importance of early recognition and diagnosis of autism is well established as this facilitates access to targeted early learning and functional supports for very young children. Despite increased knowledge on early presentations of autism in infancy and toddlerhood, children in Australia are rarely diagnosed with autism prior to four years of age. In this project, our aim was to train primary care nurses in Victoria and Tasmania on the early signs of autism at 12-, 18- and 24-months using Social Attention and Communication Surveillance – Revised (SACS-R), so that they can monitor children as part of routine child health assessments at these ages. In so doing, our overall objective was to reduce the age of diagnosis of autism at two study sites, with the implementation of SACS-R in Tasmania being a state-wide implementation.

A total of 276 nurses were successfully trained on the SACS-R with both the training and the implementation being highly evaluated across sites. In monitoring children during their routine assessments at the Victorian sites and in Tasmania, 2% and 3% of children monitored, respectively, were referred for a developmental and diagnostic assessment due to showing key early markers for autism between 12- to 24-months. While the majority of these children met criteria for a diagnosis of (83% and 60%, respectively), all remaining children who did not meet criteria for diagnosis for autism had either a developmental and/or language delay (DD/LD), with no false positive cases identified among the 19,512 children monitored. 

The study found that universal developmental surveillance of young children by trained early childhood professionals has the potential to identify those at high likelihood of autism and other developmental conditions.