Screening tools for autism spectrum disorder (ASD) often fail to identify ASD among children from low-income families and racial/ethnic minority groups, particularly when English is not the family’s primary language. A new visually-based tool may reduce these disparities at a pivotal point in children’s development.
In Pediatrics, Zuleyha Cidav, David Mandell, and colleagues found that the Developmental Check-In Tool (DCI) can accurately identify ASD risk among young children from families that have low income or speak English as a second language.
Most of the sample was Hispanic, enrolled in Medicaid or uninsured, and from families where English was not the primary language. The DCI is written in both English and Spanish, and it includes 26 pictures in four domains: communication, play, social, and behavior. Each picture includes a brief description.
Consistent with an earlier study, the DCI showed a good ability to distinguish between children with ASD and children without ASD, performing well across all age groups, genders, levels of maternal education, primary language, and racial/ethnic groups included in the study.
The DCI can improve ASD identification among children from families with low literacy or limited English proficiency. Even though ASD can be diagnosed in children as young as 18 months, on average, children in the U.S. receive an ASD diagnosis at age four. Earlier recognition of ASD is critical for early intervention and improved functional outcomes. While the disparity in ASD diagnoses between Black and white children has improved over time, Hispanic children continue to be diagnosed at a lower rate. The DCI could lead to earlier and more accurate ASD diagnoses for this group.
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