Spotting Signs of Autism in 3-Year-Olds: Comparing Information from Parents and Preschool Staff.
Elisabeth Nilsson Jobs, Sven Bölte, Terje Falck-Ytter
PMID 30465293WHAT IT FOUND
Preschool staff reports separated 3-year-olds with autism from high-risk siblings without autism and low-risk controls better than parent reports.
Staff reports also matched clinical autism observation more closely, but two of 10 children with autism were missed.
Key findings
01Preschool staff ratings separated children with autism from high-risk children without autism and low-risk controls; parent ratings did not separate children with autism from high-risk children without autism.
02In high-risk children, preschool staff pervasive developmental problems ratings were associated with clinical autism observation scores; parent ratings on the same scale were not.
03Preschool staff did not identify every child with autism: two out of 10 children with autism scored zero on the preschool pervasive developmental problems scale.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The final sample was small, with 56 children total and only 10 children with autism. All high-risk families had an older child with autism and were recruited from a sibling study, which may bias parent ratings of the younger child. The study was done in Sweden, where 93% of 3-year-olds attend preschool, so results may not generalize to settings with different preschool staffing, education, or attendance. The preschool staff ratings were not perfectly sensitive: two out of 10 children with autism scored zero on the Pervasive Developmental Problems scale. The Pervasive Developmental Problems scale used was the older 13-item version, which includes an item removed from the current DSM-ASD scale. The study compared existing rating forms; it did not test whether including preschool staff information improves clinical decisions.
Declared interests
The study was funded by Svenska Forskningsrådet Formas and Riksbankens Jubileumsfond. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not conclude that preschool staff can diagnose autism or that parent report is unreliable. The staff ratings were closer to clinical observation on some scales, but two out of 10 children with autism scored zero on the preschool Pervasive Developmental Problems scale, so staff report alone can miss autism.