A questionnaire could help identify children at risk for autism in their first year of life, new research shows, and that could affect how early children start intervention programs as well as those programs' effectiveness.

"Identification of children at risk for [autism spectrum disorder] at 12 months could provide a substantial number of children and their families with access to intervention services months or years before they would otherwise receive a traditional diagnosis," study co-author Lauren Turner-Brown, a researcher with the Program for Early Autism, Research, Leadership and Service at the University of North Carolina School of Medicine said in a statement.

Nearly 700 parents completed the "First Year Inventory" questionnaire, designed by University of North Carolina researchers. The survey asks roughly 60 questions about things like reactivity, repetitive behavior and expressive communication -- all of which can provide hints about whether or not a child is autistic.

The parents also filled out screening questionnaires when their children turned 3.

More than 30 percent of the children believed to be at-risk for an autism spectrum disorder based on answers provided at age 1, were diagnosed with the disorder by age 3. Eighty-five percent of the children who were at-risk based on answers when they were 1, had other developmental challenges that called for evaluation or intervention by age 3.

Overall, the researchers called those results "encouraging."

"Whenever you develop a screening instrument, the two concerns are false positive and false negatives," said Steven Meyers, a professor of psychology at Roosevelt University and a Chicago-based clinical psychologist who was not a part of the new study.
"A false positive means a child is identified as at-risk for autism, but does not develop it. A false negative means a child will have autism, but the instrument did not pick it up. It offers a false sense of security."

The new study, published in the journal Autism, found very low rates of false positives associated with the First Year Inventory. There was a slightly higher rate of false negatives, but that was also relatively low, Meyers said.

The American Academy of Pediatrics recommends that all children get some form of autism screening at 18 and 24 months, or earlier if parents have particular concerns. It "strongly believes" in the importance of early and continuous screening, which can lead to early intervention.

Though there is no cure for autism spectrum disorders, which typically begin before age 3 and last a lifetime, research has shown that programs can greatly improve children's development, helping them walk, talk and interact.

The authors of the new study say that at the very least their findings could identify high-risk infants so they can study early symptoms, as well as how well early intervention programs work. If additional studies verify the new findings, the questionnaire also could be helpful in clinical settings, allowing doctors and parents to identify at-risk children at earlier ages, they say.

But even then, Meyers cautioned, the results must be kept in perspective: The questionnaire is a possible screening tool, not a diagnostic instrument. Screening tools simply alert parents and doctors to the fact that an in-depth evaluation may be necessary. Then, it is up to health-care providers to diagnose autism or another developmental difficulty.

"A screening test is always the first step," said Meyers. "It is never the last word."