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TABLE 1

Developmental Screening Tools

DescriptionAge RangeNo. of ItemsAdministration TimePsychometric Properties aScoring MethodCultural ConsiderationsPurchase/Obtainment InformationKey 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 
DescriptionAge RangeNo. of ItemsAdministration TimePsychometric Properties aScoring MethodCultural ConsiderationsPurchase/Obtainment InformationKey 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

a

Sensitivity and specificity were categorized as follows: low = 69 or below; moderate = 70 to 89; high = 90 or above.

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