Skip to main content
SpringerLink
Log in

Early detection of autism. Diagnostic instruments for clinicians

  • Review
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Autism and Asperger syndrome are disorders with early childhood onset. They are believed to exist on the same spectrum of impairments of reciprocal communication and social interaction restriction of imagination and behaviour. A number of screening and diagnostic tools have been developed in the field, and several of these are briefly reviewed here. It is concluded that autism may be screened around age 18 months and a diagnosis reliably be made around age 30 months, whereas a diagnosis of Asperger syndrome is not usually suspected, screened or made until into the child's school age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adrien JL, Barthélémy C, Perrot A, Roux S, Lenoir P, Hameury L, Sauvage D (1992) Validity and reliability of the Infant Behavioural Summarized Evaluation (IBSE): A rating scale for the assessment of young children with autism and developmental disorders. Journal of Autism and Developmental Disorders 22:375–394

    Google Scholar 

  2. American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders. (Third Edition — Revised). APA, Washington, DC

    Google Scholar 

  3. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders. (Fourth Edition). APA, Washington, DC

    Google Scholar 

  4. Baron-Cohen S (1995) Mind Blindness. An Essay on Autism and Theory of Mind. Cambridge: MIT Press

    Google Scholar 

  5. Baron-Cohen S, Allen J, Gillberg C (1992) Can autism be detected at 18 months? The needle, the haystack and the CHAT. British Journal of Psychiatry 161:839–843

    Google Scholar 

  6. Barthélémy C, Adrien JL, Tanguay P, Garreau B, Fermanian J, Roux S, Sauvage D, Lelord G (1990) The Behavioral Summarized Evaluation. Validity and reliability of a scale for the assessment of autistic behaviors. Journal of Autism and Developmental Disorders 20 (2):189–204

    Google Scholar 

  7. Barthélémy C, Adrien JL, Roux S, Garreay B, Perrot A, Lelord G (1992) Sensitivity and specificity of the Behavioural Summarized Evaluation (BSE) for the assessment of autistic behaviours. Journal of Autism and Developmental Disorders 22:23–31

    Google Scholar 

  8. Bernsen AH (1980) The childrens' Handicap, Behaviour and Skills (HBS). A report on its reliability under Danish conditions. Acta Psychiatrica Scandinavica 62 Suppl 285:133–139

    Google Scholar 

  9. Bolton P, Rutter M (1990) Genetic influences in autism. International Review of Psychiatry 2:67–80

    Google Scholar 

  10. Campbell M, Geller B, Small AM, Petti TA, Ferris SH (1978) Minor physical anomalies in young psychotic children. American Journal of Psychiatry 135:573–575

    Google Scholar 

  11. Chess S (1977) Follow-up report on autism in congenital rubella. Journal of Autism and Childhood Schizophrenia 7:69–81

    Google Scholar 

  12. Clark P, Rutter M (1979). Task difficulty and task performance in autistic children. Journal of Child Psychology and Psychiatry 20:271–285

    Google Scholar 

  13. Cohen IL, Sudhalter V, Landon-Jimenez D, Keogh M (1993) A neural network approach to the classification of autism. Journal of Autism and Developmental Disorders 23:443–466

    Google Scholar 

  14. Dahlgren SO, Gillberg C (1989) Symptoms in the first two years of life. A preliminary population study of infantile autism. European Archives of Psychiatry and Neurological Sciences 238:169–174

    Google Scholar 

  15. DiLavore PC, Lord C, Rutter M (1995) The pre-linguistic autism diagnostic observation schedule. Journal of Autism and Developmental Disorders 25:355–379

    Google Scholar 

  16. Doll E (1965) Vineland Social Maturity Scale. (Revised ed.). Circle Pines, Minnesota: American Guidance Service, Inc

    Google Scholar 

  17. Ehlers S, Gillberg C (1993) The epidemiology of Asperger syndrome. A total population study. Journal of Child Psychology and Psychiatry 34:1327–1350

    Google Scholar 

  18. Ekman G, Miranda-Linne F, Gillberg C, Garle M, Wetterberg L (1989) Fenfluramine treatment of twenty children with autism. Journal of Autism and Developmental Disorders 19:511–532

    Google Scholar 

  19. Fernell E, Gillberg C, von Wendt L (1991) Autistic symptoms in children with infantile hydrocephalus. Acta Paediatrica Scandinavica 80:451–457

    Google Scholar 

  20. Freeman BJ, Ritvo ER, Yokota A, Ritvo A (1986) A scale for rating symptoms of patients with the syndrome of autism in real life settings. Journal of the American Academy of Child Psychiatry 25:130–136

    Google Scholar 

  21. Frith U (Ed.) (1991) Autism and Asperger Syndrome. Cambridge: Cambridge University Press

    Google Scholar 

  22. Gillberg C (1990) Autism and pervasive developmental disorders: published erratum appears in J Child Psychol Psychiatry 1991 Jan; 32(1):213. Journal of Child Psychology and Psychiatry 31: 99–119

    Google Scholar 

  23. Gillberg C (1991) Clinical and neurobiological aspects of Asperger syndrome in six family studies. In: Frith U (ed) Autism and Asperger Syndrome (pp. 122–146). Cambridge: Cambridge University Press

    Google Scholar 

  24. Gillberg C, Coleman M (1992) The Biology of the Autistic Syndromes. Clinics in Developmental Medicine No 126. (2nd edition). London, New York: Mac Keith Press

    Google Scholar 

  25. Gillberg C, Ehlers S, Schaumann H, Jakobsson G, Dahlgren SO, Lindblom R, Bagenholm A, Tjuus T, Blidner E (1990) Autism under age 3 years: a clinical study of 28 cases referred for autistic symptoms in infancy. Journal of Child Psychology and Psychiatry 31:921–934

    Google Scholar 

  26. Gillberg C, Ehlers S, Wing L (1996) The development of a questionnaire for Asperger syndrome and other autism spectrum disorders. In progress

  27. Gillberg IC, Gillberg C (1989) Asperger syndrome — some epidemiological considerations: a research note. Journal of Child Psychology and Psychiatry 30:631–638

    Google Scholar 

  28. Gillberg IC, Gillberg C, Ahlsén G (1994) Autistic behaviour and attention deficits in tuberous sclerosis. A population-based study. Developmental Medicine and Child Neurology 36:50–56

    Google Scholar 

  29. Gillberg C, Nordin V (1994). Autism och autismliknande tillstånd — en översikt. Stockholm: Riksföreningen Autism (In Swedish)

    Google Scholar 

  30. Haracopos D, Kelstrup A (1978) Psychotic behaviour in children under the institutions for the mentally retarded in Denmark. Journal of Autism and Childhood Schizophrenia 8:1–12

    Google Scholar 

  31. Hunt A, Shepherd C (1993) A prevalence study of autism in tuberous sclerosis. Journal of Autism and Developmental Disorders 23:323–339

    Google Scholar 

  32. Jenssen Hagerman RJ, Cronister Silverman A (1991) Fragile X Syndrome. Diagnosis, Treatment, and Research. Baltimore and London: The John Hopkins University Press

    Google Scholar 

  33. Johnson MH, Siddons F, Frith U, Morton J (1992) Can autism be predicted on the basis of infant screening tests? Developmental Medicine and Child Neurology 34:316–320

    Google Scholar 

  34. Krug DA, Arick J, Almond P (1980). Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. Journal of Child Psychology and Psychiatry 21:221–229

    Google Scholar 

  35. Le Couteur A, Rutter M, Lord C, Rios P, Robertson S, Holdgrafer M, McLennan J (1989). Autism diagnostic interview: a standardized investigator-based instrument. Journal of Autism and Developmental Disorders 19:363–387

    Google Scholar 

  36. Lelord G, Muh JP, Barthélémy C, Martineau J, Garreau B, Callaway E (1981) Effects of pyridoxine and magnesium on autistic symptoms — initial observations. Journal of Autism and Developmental Disorders 11:219–230

    Google Scholar 

  37. Links PS, Stockwell M, Abichandi F, Simeon J (1980) Minor physical anomalies in childhood autism: Part I. Their relationship to pre- and perinatal complications. Journal of Autism and Developmental Disorders 10:273–285

    Google Scholar 

  38. Lord C, Rutter M, Le Couteur A (1994) Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders 24:659–685

    Google Scholar 

  39. Lord C, Rutter M, Goode S, Heemsbergen J, Jordan J, Mawhood L, Schopler E (1989) Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders 19:185–212

    Google Scholar 

  40. Lund J, Jensen J (1989) Dimensional approach to infantile autism in mentally retarded adults. Acta Psychiatrica Scandinavica 80:389–394

    Google Scholar 

  41. Nordin V, Gillberg C (1996) Autism spectrum disorders in children with physical or mental disability or both. Part I: Clinical and epidemiological aspects. Developmental Medicine and Child Neurology 38:313

    Google Scholar 

  42. Ort M, Liepmann MC (1981) The schedule of children's handicaps, behaviors and skills: Reliability and discrimination. In: Mittler P (ed) Frontiers of knowledge in mental retardation. Proceedings of the 5th congress of the International association for the Scientific study of Mental Deficiency. Baltimore, MD: University Park Press

    Google Scholar 

  43. Osterling J, Dawson G (1994) Early recognition of children with autism: A study of first birthday home video-tapes. Journal of Autism and Developmental Disorders 24:247–257

    Google Scholar 

  44. Parks SL (1983) The assessment of autistic children: a selective review of available instruments. Journal of Autism and Developmental Disorders 13:255–267

    Google Scholar 

  45. Riikonen R, Amnell G (1981) Psychiatric disorders in children with earlier infantile spasms. Developmental Medicine and Child Neurology 23:747–760

    Google Scholar 

  46. Ritvo ER, Freeman BJ, Yuwiler A, Geller E, Yokota A, Schroth P, Novak P (1984) Study of fenfluramine in outpatients with the syndrome of autism. Journal of Pediatrics 105:823–828

    Google Scholar 

  47. Schopler E, Reichler RJ, Renner BR (1988) The Childhood Autism Rating Scale (CARS). Revised. Los Angeles: Western Psychological Services, Inc

    Google Scholar 

  48. Sevin JA, Matson JL, Coe DA, Fee VE, Sevin BM (1991) A comparison and evaluation of three commonly used autism scales. Journal of Autism and Developmental Disorders 21:417–432

    Google Scholar 

  49. Smith DE, Miller SD, Stewart M, Walter TC, McConnel JV (1988) Conductive hearing loss in autistic learning-disabled and normal children. Journal of Autism and Developmental Disorders, 1:53–65

    Google Scholar 

  50. Spiker D, Lotspeich L, Kraemer HC, Hallmayer J, McMahon W, Petersen PB, Nicholas P, Pingree C, Wiese-Slater S, Chiotti C, Wong DL, Dimicelli S, Ritvo E, Cavalli-Sforza LL, Ciaranello RD (1994) Genetics of autism: Characteristics of affected and unaffected children from 37 multiplex families. American Journal of Medical Genetics 54:27–35

    Google Scholar 

  51. Steffenburg S, Gillberg C, Steffenburg U (1992) Psychiatric problems in children with mental retardation and seizure disorders. A population-based study. Abstract at WHO conference, Goteborg 1992

  52. Swettenham J (1995) Detection of Autism in Primary Care. Paper presented at the ACPP—MIDLANDS BRANCH RESEARCH DAY — Advances in the Assessment of Autism, Birmingham, England

  53. Szatmari P (1992) The validity of autistic spectrum disorders: a literature review. Journal of Autism and Developmental Disorders 22:583–600

    Google Scholar 

  54. Szatmari P, Brenner R, Nagy J (1989) Asperger's syndrome: a review of clinical features. Canadian Journal of Psychiatry 34:554–560

    Google Scholar 

  55. Van Berckelaer-Onnes I, van Duijn G (1993) A comparison between the Handicaps Behaviour and Skills schedule and the Psychoeducational Profile. Journal of Autism and Developmental Disorders 23:263–272

    Google Scholar 

  56. Volkmar FR, Cicchetti DV, Dykens E, Sparrow, SS, Leckman JF, Cohen DJ (1988) An evaluation of the Autism Behavior Checklist. Journal of Autism and Developmental Disorders 18:81–97

    Google Scholar 

  57. Wadden NPK, Bryson SE, Rodger, RS (1991) A closer look at the Autism Behavior Checklist: Discriminant validity and factor structure. Journal of Autism and Developmental Disorders, 21:529–541

    Google Scholar 

  58. Walker H (1976) The incidence of minor physical anomalies in autistic children. In: Coleman M (ed) The Autistic Syndromes. Amsterdam: North-Holland, pp. 95–116

    Google Scholar 

  59. Wing L (1981) Asperger's syndrome: a clinical account. Psychological Medicine 11:115–129

    Google Scholar 

  60. Wing L (1989) The diagnosis of autism. In: Gillberg C (ed) Diagnosis and Treatment of Autism. New York: Plenum Press

    Google Scholar 

  61. Wing L (1993) The definition and prevalence of autism: A review. European Child & Adolescent Psychiatry 2:61–74

    Google Scholar 

  62. Wing L, Gould J (1978) Systematic recording of behaviors and skills of retarded and psychotic children. Journal of Autism and Childhood Schizophrenia 8:79–97

    Google Scholar 

  63. Wing L, Gould J (1982) Schedule of handicaps, behavior and skills. 3rd ed. London: MRC Social Psychiatry Unit

    Google Scholar 

  64. Wing L, Gould J (1994) Schedule of handicaps, behavior and skills. 3rd revised. London: MRC Social Psychiatry Unit

    Google Scholar 

  65. World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: Author.

    Google Scholar 

  66. Yirmiya N, Sigman M, Freeman BJ (1994) Comparison between diagnostic instruments for identifying high-functioning children with autism. Journal of Autism and Developmental Disorders 24:281–291

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, University of Göteborg Annedals Clinics, 413 45, Göteborg, Sweden

    C. Gillberg, V. Nordin & S. Ehlers

Authors
  1. C. Gillberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Nordin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Ehlers
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gillberg, C., Nordin, V. & Ehlers, S. Early detection of autism. Diagnostic instruments for clinicians. European Child & Adolescent Psychiatry 5, 67–74 (1996). https://doi.org/10.1007/BF01989498

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01989498

Key words

Search

Navigation