✅ Autism Screening in Children – When, How & Why Early Diagnosis Matters
Autism is not always obvious in the early years. Many children with autism don’t have physical abnormalities. They might smile sometimes, play with toys, or say a few words — leading parents to believe “speech will come later” or “he’s just shy.”
By the time the child is 4–5 years old and schools start rejecting admission, the family realizes something is wrong.
But precious time is lost.
That is why early screening for autism (before age 3) is one of the most important steps in child development. The earlier we identify, the earlier we can start therapy — when the brain is most flexible (neuroplasticity).
🌟 Screening vs Diagnosis – What’s the Difference?
| Screening | Diagnosis |
|---|---|
| Quick checklist or test | Detailed clinical evaluation |
| Identifies children at risk | Confirms autism officially |
| Can be done by parents, teachers, pediatricians | Done by psychiatrists / developmental pediatricians |
| Example: M-CHAT, ISAA screening questions | Example: ADOS, CARS, DSM-5 criteria |
Screening ≠ Labeling.
It simply tells us: Should we evaluate further or not?
🍼 When Should Autism Screening Be Done?
✅ At 18 months and 24 months (as per AAP guidelines)
✅ For any child with:
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Speech delay
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No eye contact or name response
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Limited social interaction
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Sibling with autism
✅ For high-risk groups: Preterm birth, seizures, developmental delay
🚨 Early Signs of Autism – Red Flags to Watch For
By 12 Months
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No social smile
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No eye contact
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Doesn’t respond to name
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Doesn’t point or wave
By 18 Months
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No meaningful words like “mama,” “papa”
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Doesn’t point to objects to show interest
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Prefers to play alone
By 24 Months
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No two-word meaningful sentences
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Repeats dialogues from TV (echolalia)
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Covers ears to sound / stares at spinning objects
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Walks on toes / lines up toys
📋 Common Autism Screening Tools (Used in India & Worldwide)
| Tool | Age Group | Who Can Use | Notes |
|---|---|---|---|
| M-CHAT-R (Modified Checklist for Autism in Toddlers) | 16–30 months | Parent questionnaire | 20 questions, quick & easy |
| CARS (Childhood Autism Rating Scale) | 2+ years | Clinician | Used for severity scoring |
| ISAA (Indian Scale for Assessment of Autism) | 3–9 years | Trained professionals | Developed by NIMHANS + RCI; culturally adapted |
| INCLEN Tool | 2–9 years | Pediatricians/psychologists | Used in Indian population-based studies |
| STAT / SCQ / ADOS | 2+ years | Specialists | For detailed assessment |
📱 Example – M-CHAT Screening Questions (Simplified)
✔ Does your child look at you when you call his/her name?
✔ Does your child point to show you something interesting?
✔ Does your child bring objects to show you (toy, book)?
✔ Does your child imitate actions (clapping, waving)?
✔ Does your child enjoy playing with other children?
If more than 3 answers are concerning, further evaluation is recommended.
🩺 Who Should Do the Screening?
| Person | Role |
|---|---|
| Parents | First to notice delays; can use M-CHAT online/checklist |
| Pediatricians | Should screen during vaccination visits |
| Preschool teachers | Can identify social and language delays |
| Child psychiatrists/developmental pediatricians | Detailed evaluation, diagnosis, therapy planning |
🧠 Why Early Screening Saves Lives (and Futures)
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Brain is most plastic between 0–6 years
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Early therapy improves speech, social skills, attention, learning
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Prevents severe aggression, school failure, social isolation
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Supports parents mentally, emotionally & educationally
Delayed diagnosis = harder therapy + more guilt + more suffering.
🇮🇳 Why Autism Screening Is Delayed in India
❌ Stigma: “Beta thoda late bolega, normal hai”
❌ Family says: “Boys talk late, don’t worry”
❌ Misdiagnosed as speech delay, mobile addiction, parenting issue
❌ Schools refuse admission instead of guiding parents
✅ Solution: Awareness + Screening + Early Intervention
✅ What Should Parents Do If Screening Is Positive?
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Don’t panic or Google worst-case scenarios
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Visit a child psychiatrist/developmental pediatrician
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Child will be assessed with structured tools + observation
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Start speech therapy / ABA / OT without delay
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Reduce screen time, increase interaction, naming, eye contact
👨⚕️ About the Author
Dr. Srinivas Rajkumar T
MD (AIIMS), DNB Psychiatry
Consultant Child & Adolescent Psychiatrist
Mind & Memory Clinic – Apollo Clinic (Opp. Phoenix MarketCity), Velachery, Chennai – 600042
📞 +91-8595155808 | 🌐 www.srinivasaiims.com
Specialist in early diagnosis of Autism, ADHD, Speech Delay, AuDHD, and parent-guided early intervention planning.