Screening for Early Signs of Autism and Age of Detection in Babies, Infants, and Toddlers

The diagnose of autism is usually made by professionals at ages of 2 to 4 years. However, there have been a number of studies which have discovered that there are a number of signs which can be used to detect or recognize autistic children at 1st birth day or 18 months with good prediction rate. We summarize these signs from the results of four studies for earlier detection by parents.  Parents are advised to seek for further diagnoses by pediatrician by age 18-24 months in order to get early intervention to improve children’s developmental outcomes.     

(1) Early detection can be made at 1st birthday:  according to the results of 2 studies, there have been 4 behavioral signs showed at first birthday between later-diagnosed cases of autistic and non-autistic children. The results have been shown that the accurate rate of prediction is 10/11 (“correctly classified 10 of 11 autistic children and 10 of 11 normal children”). First, autistic failed more often to orient to their names being called at 1st birthday. Second, non-autistic children show an object to another more often than autistic children. Third, the non-autistic children look at another more often than autistic children. Forth, children with autism are unable to point at 1st birthday.


(2) Checklist to detect autism at age of 18-24 months: According to results of 2 studies, 23 items in the Modified Checklist for Autism in Toddlers (M-CHAT) can be made at age of 18-24 months with good sensitivity and predication rate (has a sensitivity rate of 0.87, specificity rate of 0.99, positive prediction power of 0.8 and negative predict power of o.99). 

It is worthwhile to mention that even though the first checkup can be made at 18 months, some children do display regression between the ages of 15-24 months. Therefore, parents can make an initial checkups at 18 months or check up again at 24 months if they are concerned about children’s regression.

Below are 23 items of M-CHAT which are adopted from the researchers who made M-CHAT (Robins, Fein, Barton, & Green, p. 12, 2001).  Parents can use to detect autism at 18 months. If the behavior is rare, for example, less than once or twice, it is considered “does not”).

  1. Does your child enjoy being swung, bounced on your knee, etc? 

  2. Your child does not take an interest in other children.

  3. Your child does not like climb on things, such as stairs.

  4. Your child does not enjoy play peek-a-boo or hide-and-seek.

  5. Your child has never or near to never (less than once or twice) pretend play, for example, to talk on the phone or take care of dolls, or pretend other things.

  6. Your child has never or near to never (less than once or twice) to use his/her index finger to point, to ask for something.

  7. A child has never or near to never (less than once or twice) to use his/her index finger to point, to indicate interest in something.

  8. A child cannot play properly with small toys (e.g. cars, bricks) and just mounting, fiddling, and dropping.

  9. A child has never or nearly to never to bring objects over to you to show you something.   

  10. A child cannot look you in the eye more than a second or to.

  11. A child seems not to be sensitive to noise (e.g. plugging ears).

  12. A child does not smile in response to your or others’ faces.

  13. A child does not imitate you. (e.g. you make a face-will your child imitate it?)

  14. A child respond to his/her name when you call.

  15. If you point a toy across the room, your child does not look at.

  16. Does your child walk?

  17. Your child does not look at things you are looking at.

  18. Your child makes an unusual finger movement near his/her face.

  19. Your child does not try to get your attention to his/her own activity.

  20. You have wondered if your child is deaf.

  21. Your child does not understand what people say.

  22. Your child sometimes stare at nothing or wander with no purpose.

  23. Your child does not look at your face to check your reaction when faced with something unusual.”

(Robins, Fein, Barton, & Green, p. 142, 2001).

The cutoff: Non-autistic children fail less than 6.4 items on average, whereas autistic children failed 10.3 on average.

Created on December 09 2015 at 12: 35 AM

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Details of Scientific Answers: Click on each bullet to Read References


1: "The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders," Journal of autism and developmental disorders, 2001, by Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. . (Citations: 1106).

2: "Early indicators of autism spectrum disorders in the second year of life," Journal of autism and developmental disorders, 2004, by Wetherby, A. M., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. . (Citations: 414).


1: "Early recognition of children with autism: A study of first birthday home videotapes," Journal of autism and developmental disorders, 1994, by Osterling, J., & Dawson, G. . (Citations: 1036).

2: "Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation," Development and psychopathology, 2002, by Osterling, J. A., Dawson, G., & Munson, J. A. . (Citations: 580).

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