Course Title: Plenary C - Early Detection of Autism Spectrum Disorder (Robins)
Credit Hours: 1
Instructor(s) Diana L. Robins
Early Detection of Autism Spectrum Disorder
Abstract & Learning Objectives:
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects 1 in 54 children. Symptoms manifest during the first years of life, yet most children are not diagnosed until they are 3-5 years old. Subsequently, initiation of ASD-specific early intervention is delayed, which impacts outcomes across the lifespan. Although many labs have explored potential biomarkers in infants and toddlers, behavioral detection and diagnosis remain the current standard. This presentation will review the common warning signs of ASD in toddlers, using video examples to illustrate key behaviors that differentiate toddlers with ASD from those with other developmental delays and typical development, such as joint attention and pretend play. I will describe strategies used to detect ASD risk in toddlers; conflicting guidelines for primary care providers, often the only experts to see very young children; and how utility of screening tools is evaluated, with emphasis on sensitivity, specificity, and positive predictive value. Using examples from the literature on the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), I will discuss challenges and opportunities in early detection of ASD.
Upon conclusion of this course, learners will be able to:
- List common warning signs for ASD in toddlers
- Describe strategies for detection of ASD before age 2, including conflicting guidelines for primary care providers
- Discuss utility of screening tools, including sensitivity and specificity, and review evidence for universal ASD-specific screening
Dr. Diana L. Robins is a Professor and the Director of the AJ Drexel Autism Institute at Drexel University, the first research center to focus on public health science of autism. The Institute aims to understand and address challenges of autism though population-level and community-based science, in order to reduce disability and maximize quality of life for autistic people and their families. The Institute’s research programs address risk and protective factors, early detection and intervention, and life course outcomes of individuals with autism, as well as policy affecting access to services. Dr. Robins also leads the Institute’s research program in Early Detection and Intervention for ASD. She holds secondary appointments in Community Health and Prevention in the Dornsife School of Public Health and Psychology in the College of Arts and Sciences at Drexel University.
Much of Dr. Robins’ work has centered around developing, validating, and refining a widely-used parent-report screening tool for ASD, the Modified Checklist for Autism in Toddlers, or M-CHAT. The original M-CHAT paper has been cited more than 1900 times, and the validation of the tool’s revision, M-CHAT-R with Follow-Up (M-CHAT-R/F), demonstrated that the 2-stage screening questionnaire detects many cases of autism, and children in the study were diagnosed about two years younger than the national median, which improves access to ASD-specific early intervention. Her recent studies examine the optimal ages for primary care screening to detect autism risk, opportunities to screen in community settings outside the medial home, and a randomized controlled trial to relate early detection in primary care to early intervention and positive outcomes by age 5.
Dr. Robins’ research has been funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Autism Speaks, and the National Institute of Mental Health. Her work has been published in leading pediatric and autism journals. Her scholarly service has included serving on the editorial boards of the Journal of Autism and Developmental Disorders Autism: The International Journal of Science and Practice, and Neuropsychology, as well as the NIH study section for Child Psychopathology and Developmental Disorders, and as an elected member of the Board of Directors for the International Society for Autism Research.
Dr. Robins received her doctorate in Clinical Psychology, with an emphasis in Clinical Neuropsychology from the University of Connecticut. Following her APA-approved internship at the University of Florida Health Sciences Center, Dr. Robins completed a 2-year postdoctoral fellowship at the Yale University School of Medicine Child Study Center. She then spent 10 years on the faculty at Georgia State University, with a joint appointment in the Department of Psychology and the Neuroscience Institute, before moving to Drexel University in 2014. She is delighted that her program at the AJ Drexel Autism Institute draws students from public health, psychology, and medicine to work together on public health approaches to improving early detection and intervention for ASD.