Developmental Screening Tools
| . | Description . | Age Range . | No. of Items . | Administration Time . | Psychometric Properties a . | Scoring Method . | Cultural Considerations . | Purchase/Obtainment Information . | Key References . |
|---|---|---|---|---|---|---|---|---|---|
| General developmental screening tool | |||||||||
| Ages & Stages Questionnaires (ASQ) | Parent-completed questionnaire; series of 19 age-specific questionnaires screening communication, gross motor, fine motor, problem-solving, and personal adaptive skills; results in pass/fail score for domains | 4–60 mo | 30 | 10–15 min | Normed on 2008 children from diverse ethnic and socioeconomic backgrounds, including Spanish speaking; sensitivity: 0.70–0.90 (moderate to high); specificity: 0.76–0.91 (moderate to high) | Risk categorization; provides a cutoff score in 5 domains of development that indicates possible need for further evaluation | English, Spanish, French, and Korean versions available | Paul H. Brookes Publishing Co: 800/638-3775; www.brookespublishing.com | Squires J, Potter L, Bricker D. The ASQ User's Guide. 2nd ed. Baltimore, MD: Paul H. Brookes Publishing Co; 1999 |
| Battelle Developmental Inventory Screening Tool, 2nd ed (BDI-ST) | Directly administered tool; designed to screen personal-social, adaptive, motor, communication, and cognitive development; results in pass/fail score and age equivalent; can be modified for children with special needs | Birth to 95 mo | 100 | 10–15 min (<3 y old) or 20–30 min (≥3 y old) | Normed on 2500 children, demographic information matched 2000 US Census data; additional bias reviews performed to adjust for gender and ethnicity concerns; sensitivity: 0.72–0.93 (moderate to high); specificity: 0.79–0.88 (moderate) | Quantitative; scaled scores in all 5 domains are compared with cutoffs to determine need for referral | English and Spanish versions available | Riverside Publishing Co: 800/323-9540; www.riverpub.com | Newborg J. Battelle Developmental Inventory. 2nd ed. Itasca, IL: Riverside Publishing; 2004 |
| Bayley Infant Neurodevelopmental Screen (BINS) | Directly administered tool; series of 6 item sets screening basic neurologic functions; receptive functions (visual, auditory, and tactile input); expressive functions (oral, fine, and gross motor skills); and cognitive processes; results in risk category (low, moderate, high risk) | 3–24 mo | 11–13 | 10 min | Normed on ∼1700 children, stratified on age, to match the 2000 US Census; sensitivity: 0.75–0.86 (moderate); specificity: 0.75–0.86 (moderate) | Risk categorization; children are graded as low, moderate, or high risk in each of 4 conceptual domains by use of 2 cutoff scores | English and Spanish versions available | Psychological Corp: 800/211-8378; www.harcourtassessment.com | Aylward GP. Bayley Infant Neurodevelopmental Screener. San Antonio, TX: Psychological Corp; 1995; Aylward GP, Verhulst SJ, Bell S. Predictive utility of the BSID-II Infant Neurodevelopmental Screener (BINS) risk status classifications: clinical interpretation and application. Dev Med Child Neurol. 2000;42:25–31 |
| Brigance Screens-II | Directly administered tool; series of 9 forms screening articulation, expressive and receptive language, gross motor, fine motor, general knowledge and personal social skills and preacademic skills (when appropriate); for 0–23 mo, can also use parent report | 0–90 mo | 8–10 | 10–15 min | Normed on 1156 children from 29 clinical sites in 21 states; sensitivity: 0.70–0.80 (moderate); specificity: 0.70–0.80 (moderate) | All results are criterion based; no normative data are presented | English and Spanish versions available | Curriculum Associates Inc: 800/225-0248; www.curriculumassociates.com | Glascoe FP. Technical Report for the Brigance Screens. North Billerica, MA: Curriculum Associates Inc; 2005; Glascoe FP. The Brigance Infant-Toddler Screen (BITS): standardization and validation. J Dev Behav Pediatr. 2002;23:145–150 |
| Child Development Inventory (CDI) | Parent-completed questionnaire; measures social, self-help, motor, language, and general development skills; results in developmental quotients and age equivalents for different developmental domains; suitable for more in-depth evaluation | 18 mo–6 y | 300 | 30–50 min | Normative sample included 568 children from south St Paul, MN, a primarily white, working class community; Doig et al included 43 children from a high-risk follow-up program, which included 69% with high school education or less and 81% Medicaid; sensitivity: 0.80–1.0. (moderate to high); specificity: 0.94–0.96 (high) | Quantitative; provides age equivalents in each domain as well as SDs | English and Spanish versions available | Behavior Science Systems Inc: 612/850-8700; www.childdevrev.com | Ireton H. Child Development Inventory Manual. Minneapolis, MN: Behavior Science Systems Inc; 1992; Doig KB, Macias MM, Saylor CF, Craver JR, Ingram PE. The Child Development Inventory: a developmental outcome measure for follow-up of the high risk infant. J Pediatr. 1999;135:358–362 |
| Child Development Review-Parent Questionnaire (CDR-PQ) | Parent-completed questionnaire; professional-completed child development chart measures social, self-help, motor, and language skills | 18 mo to 5 y | 6 open-ended questions and a 26-item possible-problems checklist to be completed by the parent, followed by 99 items crossing the 5 domains, which may be used by the professional as an observation guide or parent-interview guide | 10–20 min | Standardized with 220 children aged 3–4 y from primarily white, working class families in south St Paul, MN; sensitivity: 0.68 (low); specificity: 0.88 (moderate) | Risk categorization; parents' responses to the 6 questions and problems checklist are classified as indicating (1) no problem; (2) a possible problem; or (3) a possible major problem | English and Spanish versions available | Behavior Science Systems Inc | Ireton H. Child Development Review Manual. Minneapolis, MN: Behavior Science Systems; 2004 |
| Denver-II Developmental Screening Test | Directly administered tool; designed to screen expressive and receptive language, gross motor, fine motor, and personal-social skills; results in risk category (normal, questionable, abnormal) | 0–6 y | 125 | 10–20 min | Normed on 2096 term children in Colorado; diversified in terms of age, place of residence, ethnicity/cultural background, and maternal education; sensitivity: 0.56–0.83 (low to moderate); specificity: 0.43–0.80 (low to moderate) | Risk categorization; pass or fail for each question, and these responses are compared with age-based norms to classify children as in the normal range, suspect, or delayed | English and Spanish versions available | Denver Developmental Materials: 800/419-4729; www.denverii.com | Frankenburg WK, Camp BW, Van Natta PA. Validity of the Denver Developmental Screening Test. Child Dev. 1971;42:475–485; Glascoe FP, Byrne KE, Ashford LG, Johnson KL, Chang B, Strickland B. Accuracy of the Denver-II in developmental screening. Pediatrics. 1992;89:1221–1225 |
| Infant Development Inventory | Parent-completed questionnaire; measures social, self-help, motor, and language skills | 0–18 mo | 4 open-ended questions followed by 87 items crossing the 5 domains | 5–10 min | Studied in 86 high-risk 8-mo-olds seen in a perinatal follow-up program and compared with the Bayley scales; sensitivity: 0.85 (moderate); specificity: 0.77 (moderate) | Risk categorization; delayed or not delayed | English and Spanish versions available | Behavior Science Systems Inc | Creighton DE, Sauve RS. The Minnesota Infant Development Inventory in the developmental screening of high-risk infants at 8 mo. Can J Behav Sci. 1988;20(special issue):424–433 |
| Parents' Evaluation of Developmental Status (PEDS) | Parent-interview form; designed to screen for developmental and behavioral problems needing further evaluation; single response form used for all ages; may be useful as a surveillance tool | 0–8 y | 10 | 2–10 min | Standardized with 771 children from diverse ethnic and socioeconomic backgrounds, including Spanish speaking; sensitivity: 0.74–0.79 (moderate); specificity: 0.70–0.80 (moderate) | Risk categorization; provides algorithm to guide need for referral, additional screening, or continued surveillance | English, Spanish, Vietnamese, Arabic, Swahili, Indonesian, Chinese, Taiwanese, French, Somali, Portuguese, Malaysian, Thai, and Laotian versions available | Ellsworth & Vandermeer Press LLC: 888/729-1697; www.pedstest.com | |
| Language and cognitive screening tools | |||||||||
| Capute Scales (also known as Cognitive Adaptive Test/Clinical Linguistic Auditory Milestone Scale [CAT/CLAMS]) | Directly administered tool; measures visual-motor/problem solving (CAT), and expressive and receptive language (CLAMS); results in developmental quotient and age equivalent | 3–36 mo | 100 | 15–20 min | Standardized on 1055 North American children aged 2–36 mo; correlations high with Bayley Scales of Infant Development; sensitivity: 0.21–0.67 in low-risk population (low) and 0.05–0.88 in high-risk populations (low to high); specificity: 0.95–1.00 in low-risk population (high) and 0.82–0.98 in high-risk populations (moderate to high) | Quantitative (developmental age levels and quotient) | English, Spanish, and Russian versions available | Paul H. Brookes Publishing Co | Voigt RG, Brown FR III, Fraley JK, et al Concurrent and predictive validity of the cognitive adaptive test/clinical linguistic and auditory milestone scale (CAT/CLAMS) and the Mental Developmental Index of the Bayley Scales of Infant Development. Clin Pediatr (Phila). 2003;42:427–432 |
| Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP): Infant Toddler Checklist | Standardized tool for screening of communication and symbolic abilities up to the 24-mo level; the Infant Toddler Checklist is a 1-page parent-completed screening tool | 6–24 mo | 24 | 5–10 min | Standardized on 2188 North American children aged 6-24 mo; correlations: 0.39–0.75 with Mullen Scales at 2 y of age; sensitivity: 0.76–0.88 in low- and at-risk children at 2 y of age (moderate); specificity: 0.82–0.87 in low-and at-risk children at 2 y of age (moderate) | Risk categorization (concern/no concern) | English version available | Paul H. Brookes Publishing Co | Wetherby AM, Prizant BM. Communication and Symbolic Behavior Scales: Developmental Profile. Baltimore, MD: Paul H. Brookes Publishing Co; 2002 |
| Early Language Milestone Scale (ELM Scale-2) | Assesses speech and language development from birth to 36 mo | 0–36 mo | 43 | 1–10 min | Small cross-sectional standardization sample of 191 children; 235 children for speech intelligibility item; sensitivity: 0.83–1.00 in low- and high-risk populations (moderate to high); specificity: 0.68–1.00 in low- and high-risk populations (low to high) | Quantitative (age equivalent, percentile, standard score) | English version available | Pro-Ed Inc: 800/897-3202; www.proedinc.com | Coplan J. Early Language Milestone Scale. Austin, TX: Pro-Ed Inc; 1993; Coplan J, Gleason JR. Test-retest and interobserver reliability of the Early Language Milestone Scale, second edition. J Pediatr Health Care. 1993;7:212–219 |
| Motor screening tools | |||||||||
| Early Motor Pattern Profile (EMPP) | Physician-administered standard examination of movement, tone, and reflex development; simple 3-point scoring system | 6–12 mo | 15 | 5–10 min | Single published report of 1247 high-risk infants; sensitivity: 0.87–0.92 (moderate to high); specificity: 0.98 (high) | Risk categorization (normal/suspect/abnormal) | English version available | See key references | Morgan AM, Aldag JC. Early identification of cerebral palsy using a profile of abnormal motor patterns. Pediatrics. 1996;98:692–697 |
| Motor Quotient (MQ) | Uses simple ratio quotient with gross motor milestones for detecting delayed motor development | 8–18 mo | 11 total milestones; 1 per visit | 1–3 min | Single published report of 144 referred children; sensitivity: 0.87 (moderate); specificity: 0.89 (moderate) | Quantitative (developmental age levels and quotient) | English version available | See key references | Capute AJ, Shapiro BK. The motor quotient: a method for the early detection of motor delay. Am J Dis Child. 1985;139:940–942 |
| Autism screening tools | |||||||||
| Checklist for Autism in Toddlers (CHAT) | Parent-completed questionnaire or interview and directly administered items designed to identify children at risk of autism from the general population | 18–24 mo | 14 (No. of questions/items [averaged]) | 5 min | Original standardization sample included 41 siblings of children with autism and 50 controls 18 mo of age in Great Britain; 6-y follow-up on 16 235 children validated using ADI-R and ICD-10 criteria resulted in low sensitivity, high specificity; revised version in process of being normed (“Q-CHAT”); sensitivity: 0.38–0.65 (low); specificity: 0.98–1.0 (high) | Risk categorization (pass/fail) | English version available | Public domain: www.nas.org.uk/profess/chat | Baird G, Charman T, Baron-Cohen S, et al. A screening instrument for autism at 18 mo of age: a 6-y follow-up study. J Am Acad Child Adolesc Psychiatry. 2000;39:694–702; Baron-Cohen S, Allen J, Gillberg C. Can autism be detected at 18 mo? The needle, the haystack, and the CHAT. Br J Psychiatry. 1992;161:839–843 |
| Modified Checklist for Autism in Toddlers (M-CHAT) | Parent-completed questionnaire designed to identify children at risk of autism from the general population | 16–48 mo | 23 (No. of questions/items [averaged]) | 5–10 min | Standardization sample included 1293 children screened, 58 evaluated, and 39 diagnosed with an autistic spectrum disorder; validated using ADI-R, ADOS-G, CARS, DSM-IV; sensitivity: 0.85–0.87 (moderate); specificity: 0.93–0.99 (high) | Risk categorization (pass/fail) | English, Spanish, Turkish, Chinese, and Japanese versions available | Public domain: www.firstsigns.com | Dumont-Mathieu T, Fein D. Screening for autism in young children: the Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. Ment Retard Dev Disabil Res Rev. 2005;11:253–262; Robins DL, Fein D, Barton ML, Green JA. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord. 2001;31:131–144 |
| Pervasive Developmental Disorders Screening Test-II (PDDST-II), Stage 1-Primary Care Screener | Parent-completed questionnaire designed to identify children at risk of autism from the general population | 12-48 mo | 22 (No. of questions/items [averaged]) | 10-15 min to complete; 5 min to score | Validated using extensive multimethod diagnostic evaluations on 681 children at risk of autistic spectrum disorders and 256 children with mild-to-moderate other developmental disorders; no sensitivity/specificity data reported for screening of an unselected sample; sensitivity: 0.85-0.92 (moderate to high); specificity: 0.71–0.91 (moderate to high) | Risk categorization (pass/fail) | English version available | Psychological Corp | Siegel B. Pervasive Developmental Disorders Screening Test-II (PDDST-II): Early Childhood Screener for Autistic Spectrum Disorders. San Antonio, TX: Harcourt Assessment Inc; 2004 |
| Pervasive Developmental Disorders Screening Test-II (PDDST-II), Stage 2-Developmental Clinic Screener | Parent-completed questionnaire; designed to detect children at risk of autism from other developmental disorders | 12–48 mo | 14 (No. of questions/items [averaged]) | 10–15 min to complete; 5 min to score | Validated using extensive multimethod diagnostic evaluations on 490 children with confirmed autistic spectrum disorder (autism, pervasive developmental disorder-not otherwise specified, or Asperger syndrome) and 194 children who were evaluated for autistic spectrum disorder but who did not receive a diagnosis on the autistic spectrum; no sensitivity/specificity data reported for screening of an unselected sample; sensitivity: 0.69–0.73 (moderate); specificity: 0.49–0.63 (low) | Risk categorization (pass/fail) | English version available | Psychological Corp | Siegel B. Pervasive Developmental Disorders Screening Test-II (PDDST-II): Early Childhood Screener for Autistic Spectrum Disorders. San Antonio, TX: Harcourt Assessment Inc; 2004 |
| Screening Tool for Autism in Two-Year-Olds (STAT) | Directly administered tool; designed as second-level screen to detect children with autism from other developmental disorders; assesses behaviors in 4 social-communicative domains: play, requesting, directing attention, and motor imitation | 24–35 mo | 12 (No. of questions/items [averaged]) | 20 min | Two samples were used: for development phase, 3 children with autism, 33 without autism; for validation sample, 12 children with autism, 21 without autism; validated using CARS, ADOS-G, and DSM-IV criteria; second-level screen; requires training workshop before administration; sensitivity: 0.83–0.92 (moderate to high); specificity: 0.85–0.86 (moderate) | Risk categorization | English version available | Wendy Stone, PhD, author: triad@vanderbilt.edu | Stone WL, Coonrod EE, Ousley OY. Brief report: Screening Tool for Autism in Two-Year-Olds (STAT): development and preliminary data. J Autism Dev Disord. 2000;30:607–612; Stone WL, Coonrod EE, Turner LM, Pozdol SL. Psychometric properties of the STAT for early autism screening. J Autism Dev Disord. 2004;34:691–701; Stone WL, Ousley OY. STAT Manual: Screening Tool for Autism in Two-Year-Olds. unpublished manuscript, Vanderbilt University, 1997 |
| Social Communication Questionnaire (SCQ) (formerly Autism Screening Questionnaire-ASQ) | Parent-completed questionnaire; designed to identify children at risk of autistic spectrum disorders from the general population; based on items in the ADI-R | ≥4 y | 40 (No. of questions/items [averaged]) | 5–10 min | Validated using the ADI-R and DSM-IV on 200 subjects (160 with pervasive developmental disorder, 40 without pervasive developmental disorder); for use in children with mental age of at least 2 y and chronologic age ≥4 y; available in 2 forms: lifetime and current; sensitivity: 0.85 (moderate); specificity: 0.75 (moderate) | Risk categorization (pass/fail) | English and Spanish versions available | Western Psychological Corp: www.wpspublish.com | Rutter M, Bailey A, Lord C. The Social Communication Questionnaire (SCQ) Manual. Los Angeles, CA: Western Psychological Services; 2003 |
| . | Description . | Age Range . | No. of Items . | Administration Time . | Psychometric Properties a . | Scoring Method . | Cultural Considerations . | Purchase/Obtainment Information . | Key References . |
|---|---|---|---|---|---|---|---|---|---|
| General developmental screening tool | |||||||||
| Ages & Stages Questionnaires (ASQ) | Parent-completed questionnaire; series of 19 age-specific questionnaires screening communication, gross motor, fine motor, problem-solving, and personal adaptive skills; results in pass/fail score for domains | 4–60 mo | 30 | 10–15 min | Normed on 2008 children from diverse ethnic and socioeconomic backgrounds, including Spanish speaking; sensitivity: 0.70–0.90 (moderate to high); specificity: 0.76–0.91 (moderate to high) | Risk categorization; provides a cutoff score in 5 domains of development that indicates possible need for further evaluation | English, Spanish, French, and Korean versions available | Paul H. Brookes Publishing Co: 800/638-3775; www.brookespublishing.com | Squires J, Potter L, Bricker D. The ASQ User's Guide. 2nd ed. Baltimore, MD: Paul H. Brookes Publishing Co; 1999 |
| Battelle Developmental Inventory Screening Tool, 2nd ed (BDI-ST) | Directly administered tool; designed to screen personal-social, adaptive, motor, communication, and cognitive development; results in pass/fail score and age equivalent; can be modified for children with special needs | Birth to 95 mo | 100 | 10–15 min (<3 y old) or 20–30 min (≥3 y old) | Normed on 2500 children, demographic information matched 2000 US Census data; additional bias reviews performed to adjust for gender and ethnicity concerns; sensitivity: 0.72–0.93 (moderate to high); specificity: 0.79–0.88 (moderate) | Quantitative; scaled scores in all 5 domains are compared with cutoffs to determine need for referral | English and Spanish versions available | Riverside Publishing Co: 800/323-9540; www.riverpub.com | Newborg J. Battelle Developmental Inventory. 2nd ed. Itasca, IL: Riverside Publishing; 2004 |
| Bayley Infant Neurodevelopmental Screen (BINS) | Directly administered tool; series of 6 item sets screening basic neurologic functions; receptive functions (visual, auditory, and tactile input); expressive functions (oral, fine, and gross motor skills); and cognitive processes; results in risk category (low, moderate, high risk) | 3–24 mo | 11–13 | 10 min | Normed on ∼1700 children, stratified on age, to match the 2000 US Census; sensitivity: 0.75–0.86 (moderate); specificity: 0.75–0.86 (moderate) | Risk categorization; children are graded as low, moderate, or high risk in each of 4 conceptual domains by use of 2 cutoff scores | English and Spanish versions available | Psychological Corp: 800/211-8378; www.harcourtassessment.com | Aylward GP. Bayley Infant Neurodevelopmental Screener. San Antonio, TX: Psychological Corp; 1995; Aylward GP, Verhulst SJ, Bell S. Predictive utility of the BSID-II Infant Neurodevelopmental Screener (BINS) risk status classifications: clinical interpretation and application. Dev Med Child Neurol. 2000;42:25–31 |
| Brigance Screens-II | Directly administered tool; series of 9 forms screening articulation, expressive and receptive language, gross motor, fine motor, general knowledge and personal social skills and preacademic skills (when appropriate); for 0–23 mo, can also use parent report | 0–90 mo | 8–10 | 10–15 min | Normed on 1156 children from 29 clinical sites in 21 states; sensitivity: 0.70–0.80 (moderate); specificity: 0.70–0.80 (moderate) | All results are criterion based; no normative data are presented | English and Spanish versions available | Curriculum Associates Inc: 800/225-0248; www.curriculumassociates.com | Glascoe FP. Technical Report for the Brigance Screens. North Billerica, MA: Curriculum Associates Inc; 2005; Glascoe FP. The Brigance Infant-Toddler Screen (BITS): standardization and validation. J Dev Behav Pediatr. 2002;23:145–150 |
| Child Development Inventory (CDI) | Parent-completed questionnaire; measures social, self-help, motor, language, and general development skills; results in developmental quotients and age equivalents for different developmental domains; suitable for more in-depth evaluation | 18 mo–6 y | 300 | 30–50 min | Normative sample included 568 children from south St Paul, MN, a primarily white, working class community; Doig et al included 43 children from a high-risk follow-up program, which included 69% with high school education or less and 81% Medicaid; sensitivity: 0.80–1.0. (moderate to high); specificity: 0.94–0.96 (high) | Quantitative; provides age equivalents in each domain as well as SDs | English and Spanish versions available | Behavior Science Systems Inc: 612/850-8700; www.childdevrev.com | Ireton H. Child Development Inventory Manual. Minneapolis, MN: Behavior Science Systems Inc; 1992; Doig KB, Macias MM, Saylor CF, Craver JR, Ingram PE. The Child Development Inventory: a developmental outcome measure for follow-up of the high risk infant. J Pediatr. 1999;135:358–362 |
| Child Development Review-Parent Questionnaire (CDR-PQ) | Parent-completed questionnaire; professional-completed child development chart measures social, self-help, motor, and language skills | 18 mo to 5 y | 6 open-ended questions and a 26-item possible-problems checklist to be completed by the parent, followed by 99 items crossing the 5 domains, which may be used by the professional as an observation guide or parent-interview guide | 10–20 min | Standardized with 220 children aged 3–4 y from primarily white, working class families in south St Paul, MN; sensitivity: 0.68 (low); specificity: 0.88 (moderate) | Risk categorization; parents' responses to the 6 questions and problems checklist are classified as indicating (1) no problem; (2) a possible problem; or (3) a possible major problem | English and Spanish versions available | Behavior Science Systems Inc | Ireton H. Child Development Review Manual. Minneapolis, MN: Behavior Science Systems; 2004 |
| Denver-II Developmental Screening Test | Directly administered tool; designed to screen expressive and receptive language, gross motor, fine motor, and personal-social skills; results in risk category (normal, questionable, abnormal) | 0–6 y | 125 | 10–20 min | Normed on 2096 term children in Colorado; diversified in terms of age, place of residence, ethnicity/cultural background, and maternal education; sensitivity: 0.56–0.83 (low to moderate); specificity: 0.43–0.80 (low to moderate) | Risk categorization; pass or fail for each question, and these responses are compared with age-based norms to classify children as in the normal range, suspect, or delayed | English and Spanish versions available | Denver Developmental Materials: 800/419-4729; www.denverii.com | Frankenburg WK, Camp BW, Van Natta PA. Validity of the Denver Developmental Screening Test. Child Dev. 1971;42:475–485; Glascoe FP, Byrne KE, Ashford LG, Johnson KL, Chang B, Strickland B. Accuracy of the Denver-II in developmental screening. Pediatrics. 1992;89:1221–1225 |
| Infant Development Inventory | Parent-completed questionnaire; measures social, self-help, motor, and language skills | 0–18 mo | 4 open-ended questions followed by 87 items crossing the 5 domains | 5–10 min | Studied in 86 high-risk 8-mo-olds seen in a perinatal follow-up program and compared with the Bayley scales; sensitivity: 0.85 (moderate); specificity: 0.77 (moderate) | Risk categorization; delayed or not delayed | English and Spanish versions available | Behavior Science Systems Inc | Creighton DE, Sauve RS. The Minnesota Infant Development Inventory in the developmental screening of high-risk infants at 8 mo. Can J Behav Sci. 1988;20(special issue):424–433 |
| Parents' Evaluation of Developmental Status (PEDS) | Parent-interview form; designed to screen for developmental and behavioral problems needing further evaluation; single response form used for all ages; may be useful as a surveillance tool | 0–8 y | 10 | 2–10 min | Standardized with 771 children from diverse ethnic and socioeconomic backgrounds, including Spanish speaking; sensitivity: 0.74–0.79 (moderate); specificity: 0.70–0.80 (moderate) | Risk categorization; provides algorithm to guide need for referral, additional screening, or continued surveillance | English, Spanish, Vietnamese, Arabic, Swahili, Indonesian, Chinese, Taiwanese, French, Somali, Portuguese, Malaysian, Thai, and Laotian versions available | Ellsworth & Vandermeer Press LLC: 888/729-1697; www.pedstest.com | |
| Language and cognitive screening tools | |||||||||
| Capute Scales (also known as Cognitive Adaptive Test/Clinical Linguistic Auditory Milestone Scale [CAT/CLAMS]) | Directly administered tool; measures visual-motor/problem solving (CAT), and expressive and receptive language (CLAMS); results in developmental quotient and age equivalent | 3–36 mo | 100 | 15–20 min | Standardized on 1055 North American children aged 2–36 mo; correlations high with Bayley Scales of Infant Development; sensitivity: 0.21–0.67 in low-risk population (low) and 0.05–0.88 in high-risk populations (low to high); specificity: 0.95–1.00 in low-risk population (high) and 0.82–0.98 in high-risk populations (moderate to high) | Quantitative (developmental age levels and quotient) | English, Spanish, and Russian versions available | Paul H. Brookes Publishing Co | Voigt RG, Brown FR III, Fraley JK, et al Concurrent and predictive validity of the cognitive adaptive test/clinical linguistic and auditory milestone scale (CAT/CLAMS) and the Mental Developmental Index of the Bayley Scales of Infant Development. Clin Pediatr (Phila). 2003;42:427–432 |
| Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP): Infant Toddler Checklist | Standardized tool for screening of communication and symbolic abilities up to the 24-mo level; the Infant Toddler Checklist is a 1-page parent-completed screening tool | 6–24 mo | 24 | 5–10 min | Standardized on 2188 North American children aged 6-24 mo; correlations: 0.39–0.75 with Mullen Scales at 2 y of age; sensitivity: 0.76–0.88 in low- and at-risk children at 2 y of age (moderate); specificity: 0.82–0.87 in low-and at-risk children at 2 y of age (moderate) | Risk categorization (concern/no concern) | English version available | Paul H. Brookes Publishing Co | Wetherby AM, Prizant BM. Communication and Symbolic Behavior Scales: Developmental Profile. Baltimore, MD: Paul H. Brookes Publishing Co; 2002 |
| Early Language Milestone Scale (ELM Scale-2) | Assesses speech and language development from birth to 36 mo | 0–36 mo | 43 | 1–10 min | Small cross-sectional standardization sample of 191 children; 235 children for speech intelligibility item; sensitivity: 0.83–1.00 in low- and high-risk populations (moderate to high); specificity: 0.68–1.00 in low- and high-risk populations (low to high) | Quantitative (age equivalent, percentile, standard score) | English version available | Pro-Ed Inc: 800/897-3202; www.proedinc.com | Coplan J. Early Language Milestone Scale. Austin, TX: Pro-Ed Inc; 1993; Coplan J, Gleason JR. Test-retest and interobserver reliability of the Early Language Milestone Scale, second edition. J Pediatr Health Care. 1993;7:212–219 |
| Motor screening tools | |||||||||
| Early Motor Pattern Profile (EMPP) | Physician-administered standard examination of movement, tone, and reflex development; simple 3-point scoring system | 6–12 mo | 15 | 5–10 min | Single published report of 1247 high-risk infants; sensitivity: 0.87–0.92 (moderate to high); specificity: 0.98 (high) | Risk categorization (normal/suspect/abnormal) | English version available | See key references | Morgan AM, Aldag JC. Early identification of cerebral palsy using a profile of abnormal motor patterns. Pediatrics. 1996;98:692–697 |
| Motor Quotient (MQ) | Uses simple ratio quotient with gross motor milestones for detecting delayed motor development | 8–18 mo | 11 total milestones; 1 per visit | 1–3 min | Single published report of 144 referred children; sensitivity: 0.87 (moderate); specificity: 0.89 (moderate) | Quantitative (developmental age levels and quotient) | English version available | See key references | Capute AJ, Shapiro BK. The motor quotient: a method for the early detection of motor delay. Am J Dis Child. 1985;139:940–942 |
| Autism screening tools | |||||||||
| Checklist for Autism in Toddlers (CHAT) | Parent-completed questionnaire or interview and directly administered items designed to identify children at risk of autism from the general population | 18–24 mo | 14 (No. of questions/items [averaged]) | 5 min | Original standardization sample included 41 siblings of children with autism and 50 controls 18 mo of age in Great Britain; 6-y follow-up on 16 235 children validated using ADI-R and ICD-10 criteria resulted in low sensitivity, high specificity; revised version in process of being normed (“Q-CHAT”); sensitivity: 0.38–0.65 (low); specificity: 0.98–1.0 (high) | Risk categorization (pass/fail) | English version available | Public domain: www.nas.org.uk/profess/chat | Baird G, Charman T, Baron-Cohen S, et al. A screening instrument for autism at 18 mo of age: a 6-y follow-up study. J Am Acad Child Adolesc Psychiatry. 2000;39:694–702; Baron-Cohen S, Allen J, Gillberg C. Can autism be detected at 18 mo? The needle, the haystack, and the CHAT. Br J Psychiatry. 1992;161:839–843 |
| Modified Checklist for Autism in Toddlers (M-CHAT) | Parent-completed questionnaire designed to identify children at risk of autism from the general population | 16–48 mo | 23 (No. of questions/items [averaged]) | 5–10 min | Standardization sample included 1293 children screened, 58 evaluated, and 39 diagnosed with an autistic spectrum disorder; validated using ADI-R, ADOS-G, CARS, DSM-IV; sensitivity: 0.85–0.87 (moderate); specificity: 0.93–0.99 (high) | Risk categorization (pass/fail) | English, Spanish, Turkish, Chinese, and Japanese versions available | Public domain: www.firstsigns.com | Dumont-Mathieu T, Fein D. Screening for autism in young children: the Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. Ment Retard Dev Disabil Res Rev. 2005;11:253–262; Robins DL, Fein D, Barton ML, Green JA. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord. 2001;31:131–144 |
| Pervasive Developmental Disorders Screening Test-II (PDDST-II), Stage 1-Primary Care Screener | Parent-completed questionnaire designed to identify children at risk of autism from the general population | 12-48 mo | 22 (No. of questions/items [averaged]) | 10-15 min to complete; 5 min to score | Validated using extensive multimethod diagnostic evaluations on 681 children at risk of autistic spectrum disorders and 256 children with mild-to-moderate other developmental disorders; no sensitivity/specificity data reported for screening of an unselected sample; sensitivity: 0.85-0.92 (moderate to high); specificity: 0.71–0.91 (moderate to high) | Risk categorization (pass/fail) | English version available | Psychological Corp | Siegel B. Pervasive Developmental Disorders Screening Test-II (PDDST-II): Early Childhood Screener for Autistic Spectrum Disorders. San Antonio, TX: Harcourt Assessment Inc; 2004 |
| Pervasive Developmental Disorders Screening Test-II (PDDST-II), Stage 2-Developmental Clinic Screener | Parent-completed questionnaire; designed to detect children at risk of autism from other developmental disorders | 12–48 mo | 14 (No. of questions/items [averaged]) | 10–15 min to complete; 5 min to score | Validated using extensive multimethod diagnostic evaluations on 490 children with confirmed autistic spectrum disorder (autism, pervasive developmental disorder-not otherwise specified, or Asperger syndrome) and 194 children who were evaluated for autistic spectrum disorder but who did not receive a diagnosis on the autistic spectrum; no sensitivity/specificity data reported for screening of an unselected sample; sensitivity: 0.69–0.73 (moderate); specificity: 0.49–0.63 (low) | Risk categorization (pass/fail) | English version available | Psychological Corp | Siegel B. Pervasive Developmental Disorders Screening Test-II (PDDST-II): Early Childhood Screener for Autistic Spectrum Disorders. San Antonio, TX: Harcourt Assessment Inc; 2004 |
| Screening Tool for Autism in Two-Year-Olds (STAT) | Directly administered tool; designed as second-level screen to detect children with autism from other developmental disorders; assesses behaviors in 4 social-communicative domains: play, requesting, directing attention, and motor imitation | 24–35 mo | 12 (No. of questions/items [averaged]) | 20 min | Two samples were used: for development phase, 3 children with autism, 33 without autism; for validation sample, 12 children with autism, 21 without autism; validated using CARS, ADOS-G, and DSM-IV criteria; second-level screen; requires training workshop before administration; sensitivity: 0.83–0.92 (moderate to high); specificity: 0.85–0.86 (moderate) | Risk categorization | English version available | Wendy Stone, PhD, author: triad@vanderbilt.edu | Stone WL, Coonrod EE, Ousley OY. Brief report: Screening Tool for Autism in Two-Year-Olds (STAT): development and preliminary data. J Autism Dev Disord. 2000;30:607–612; Stone WL, Coonrod EE, Turner LM, Pozdol SL. Psychometric properties of the STAT for early autism screening. J Autism Dev Disord. 2004;34:691–701; Stone WL, Ousley OY. STAT Manual: Screening Tool for Autism in Two-Year-Olds. unpublished manuscript, Vanderbilt University, 1997 |
| Social Communication Questionnaire (SCQ) (formerly Autism Screening Questionnaire-ASQ) | Parent-completed questionnaire; designed to identify children at risk of autistic spectrum disorders from the general population; based on items in the ADI-R | ≥4 y | 40 (No. of questions/items [averaged]) | 5–10 min | Validated using the ADI-R and DSM-IV on 200 subjects (160 with pervasive developmental disorder, 40 without pervasive developmental disorder); for use in children with mental age of at least 2 y and chronologic age ≥4 y; available in 2 forms: lifetime and current; sensitivity: 0.85 (moderate); specificity: 0.75 (moderate) | Risk categorization (pass/fail) | English and Spanish versions available | Western Psychological Corp: www.wpspublish.com | Rutter M, Bailey A, Lord C. The Social Communication Questionnaire (SCQ) Manual. Los Angeles, CA: Western Psychological Services; 2003 |
The AAP does not approve/endorse any specific tool for screening purposes. This list is not exhaustive, and other tests may be available. ADI-R indicates Autism Diagnostic Interview-R; ICD-10, International Classification of Diseases, 10th revision; ADOS-G, Autism Diagnostic Observation Schedule-Generic; CARS, Childhood Autism Rating Scale; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
Sensitivity and specificity were categorized as follows: low = 69 or below; moderate = 70 to 89; high = 90 or above.