Autism Spectrum Disorder Screening Instruments for Very Young Children: A Systematic Review

Table 6

Behaviors examined by very early ASD screeners.

(a) Level 1 ASD screening instruments

Social communication		Repetitive behaviors	Sensory	Developmental	Reactivity/temperament	Atypical information processing
Communication	Social
Early Screen for Autism Traits (ESAT)
Eye contact		Has interest in different toys	Reaction to sensory stimuli
Reacts when spoken to	Emotions understandable	Varied play	Likes cuddling
	Facial expression	Stereotyped movements
	Attracts attention
	Brings/shows objects
	Interest in people
	Smiles directly
Checklist for Early Signs of Developmental Disorder (CSEDD)
Lack of eye contact		Shows stereotyped behavior	Dislikes touching and cuddling	Does not explore, passive
Turns to name	Social smile	Lack of variable	Unusual sensory behavior	Lack of functional
Seems to be deaf	Shares enjoyment	Lack of functional		Babbling at 12 months	Overreaction to change or other
Gestures	Imitation	Unusual postures		Single words at 16 months
Follows point	Prefers aloneness	Overreaction to change or other		Spontaneous two-word phrases at 24 months
Points	Shows object for social bid			Loss of language
Instrumental communication/hand-leading	Flat affect
Infant-Toddler Checklist (ITC)
Responds to name	Emotions readable	Interest in a variety of objects		Strings sounds together
Follows point to object	Eye contact while playing	Uses objects		Variety of consonant sounds
Requests object	Shared affect	Repeats simple activity over and over		Comprehension vocabulary
Words for attention or help	Seeks attention			Block or ring stacking
Points to objects	Gets you to laugh
Waves to greet	Shows object for social attention
	Initiating through handing object
	Initiates joint attention
First-Year Inventory (FYI)
Looks when name is called		Upset when switching activities	Overly sensitive to touch	Babbles	Sleeping and waking patterns are regular
Trouble hearing	Avoids looking at you	Enjoys staring at bright lights	Ignores loud or startling sounds	Uses pincer grip	Regular feeding patterns
Looks at people when they talk	Looks at your face for comfort	Gets stuck on playing with a part of a toy	Spits out certain textures of foods	Eyes line up when looking at object
Uses communicative gestures	Plays alone for an hour or more	Body gets stuck in positions or postures	Presses against things
Responds to ‘‘Where’s —?”	Looks up from play when shown new toy	Enjoys making objects spin over and over	Enjoys rubbing or scratching objects
Uses finger to point at things	Easy to understand baby’s expressions	Stares at fingers while wiggling them	Enjoys kicking feet over and over
Plays or communicates less than in the past	Tries to get your attention to show things, or for interactive or physical games
	Imitates mouth sounds, body movements, or movements, with objects
	Tries to get attention by sound and gaze
	Seems interested in other babies

(b) Level 2 ASD screening instruments

Social communication		Repetitive behaviors	Sensory	Developmental	Reactivity/temperament	Atypical information processing	Adaptive skills
Communication	Social
Autism Observation Scale for Infants (AOSI)
Eye contact		Atypical motor behavior	Atypical sensory behavior	Motor control	Behavioral reactivity	Visual tracking
Orientation to name	Differential response to facial emotion	Insistence on specific objects/activities				Engagement of attention
Social babbling	Anticipatory social response					Disengagement of attention
Shared interest	Imitation					Transitions
	Reciprocal social smile
Coordination of eye gaze and action	Social interest and shared affect
Screening Test for Autism in Two-Year-Olds (STAT) (applied to children under 24 months)
Requests when presented with communication challenge (2 items)	Takes turns	(Lack of) functional object		Functional object
Directs attention and interacts socially (4 items)	Imitates motor acts (4 items)
Parent Observation of Early Milestones Scale (POEMS)
Eye contact		Shifts (does not shift) attention from one event to another	Cuddling	Object permanence	Demands attention	Visual tracking	Sleep; (3 items)
Imitates sounds or words	Social smiling	Explores (does not explore) new toys and environments	Reaction to pain	Muscle tone	Stability of mood		Feeding; (4 items)
Points to request	Laughs appropriately	Diverse toy play	Reaction to noise	Agility in movement	Comforted when hurt
Points to share interests	Attachment to parents	Repetitive body movements	Fearful of objects that move or make noise	Attention span	Unpredictable reactions
Coordinates gaze and point	Recognizes parents voice	Atypical use of words	Tolerance to transitions	Stacks blocks	Activity level
Points in response to question	Emotions appropriate			Pretend play	Cries to express needs
Follows adult point	Anticipation to being picked up			Communicates with	Waiting tolerance
Follows simple direction	Response to name			Visual tracking
Brings toys to request	Attention to faces
Greets	Shifts attention from object to person
Coordinates gestures and communication	Imitating
Communicates with	Social games
	Interest in birthday present and cake
	Interest in peers
	Plays with peers
Autism Diagnostic Evaluation for Children (ADEC)
Responds to verbal command	Imitation	Functional play (lack of)	Responds to every day sounds	Demonstrates use of words
Demonstrates use of words	Gaze switching from toy to person	Pretend play (lack of)
Use of gestures (waves good-bye)	Eye contact
Response to name	Reciprocity of smile
	Following point
	Anticipatory posture for being picked up
	Nesting into caregiver

placed in two categories.