Autism screening tool - world's most effective

Research has found an early screening tool for autism developed by La Trobe University researchers – and trialled as part of an Autism CRC project – is the world’s most effective.

Published in JAMA Open, the five-year study of over 13,500 Victorian children found the SACS-R to be extremely accurate in identifying very young children on the autism spectrum. Of the infants and toddlers aged 12 to 24 months identified at ‘high likelihood’ for an autism diagnosis by the tool, 83 per cent were later diagnosed with autism.

When used alongside a SACS-Preschool check, 96 per cent of children on the autism spectrum were identified by their 3.5 year health check.

Lead researcher, Associate Professor Josephine Barbaro, from La Trobe University’s Olga Tennison Autism Research Centre (OTARC), said the research points to the critical need for the SACS-R and SACS-Preschool to be rolled out across Australia and the world, as part of regular infant health checks. It is already used across two Australian states and in 10 other countries.

“Parents are often told to “wait and see” when raising queries about their child’s development. This means the average age of diagnosis is around four to five, and opportunities for early supports have been missed,” Associate Professor Barbaro said.

“Putting this extremely effective tool in the hands of a trained primary health professional, so that during their routine health checks they are also monitoring for autism, makes a huge difference to early diagnosis.

“Not only is SACS-R the world’s most effective screening tool, unlike many it can be used within the community on large populations, enabling early identification of very young children across the board,” Associate Professor Barbaro said.

Professor Barbaro said early diagnosis of autism is critical, as it leads to earlier access to affirming supports and services.

“Early diagnosis improves developmental outcomes, increases participation in schooling, and allows children to understand their needs and identity from a young age,” Associate Professor Barbaro said.

Mum Shafica Berjaoui, whose son Ayoub was showing early signs of autism when screened with the SACS-R tool at 15 months old, was able to be formally diagnosed at 22 months.

"I felt a relief…..it made the support that I needed for him available. He's developed into a very gentle young giant," said Shafica. 

Every Victorian child attending a routine health check at 12, 18 and 24 months is already monitored with the SACS-R tool, after the Victorian Government funded state-wide training for maternal and child health nurses in 2019.

The added SACS-Preschool tool can be used at the 3.5-year health check to increase the effectiveness of the identification process – though training for that is not currently funded in Victoria.

La Trobe Vice-Chancellor Professor John Dewar AO said the screening tool is an excellent example of high-impact research that can make a tangible difference to people’s lives.

“Early autism identification using this tool has already changed the lives of thousands of children and their families around the world,” Professor Dewar said.

“An extraordinary contribution by La Trobe’s autism experts, this new research will likely lead to even more countries adopting the tool and embedding screening programs into their health systems.”

The accuracy of autism screening tools used in other parts of the world is very limited, including the well-known M-CHAT, which has an accuracy level of just six per cent when used in a community-based population.

View the JAMA publication View the Final Report, Executive Summary & Research SnapshotView the Project page