When a toddler doesn’t gesture to get your attention, respond to his or her name, or enjoy playing peek-a-boo, parents are right to be concerned about the possibility of autism. Now, researchers have developed a two-minute, 10-question test called the Psychological Development Questionnaire-1 (PDQ-1) to detect autism in toddlers. The best part? The PDQ-1 has, according to a recent study involving nearly 2,000 kids, an 88 percent likelihood of making a correct diagnosis.
“The PDQ-1 may be a quick and reliable autism screener for young children,” coauthor on the study Walter Zahorodny of Rutgers University in New Jersey told Fatherly. “Use of a screener like the PDQ-1 may enhance our ability to identify autism earlier and get more children to receive early intervention and have better long-term developmental outcomes.”
Roughly 1 in 68 children will be diagnosed with autism spectrum disorder, according to the Centers for Disease Control and Prevention. When parents notice the signs of autism early on, children can often get help and learn to live somewhat independent, normal lives. That’s why the American Academy of Pediatrics has been calling on universal autism screening at 18 and 24 months since 2007. The problem is that “a dominant screener has not emerged,” Zahorodny says. The PDQ-1’s only real competition, the MCHAT-R/F, suffers from “weak positive predictive value and requires a follow-up interview stage to avoid excessive false positives,” he adds.
“I believe that most pediatricians and other primary care providers who want to screen for autism during the toddler period do not see the MCHAT-R/F as a practical tool.”
The PDQ-1—which Zahorodny tested on 1,959 low-risk toddlers between the ages of 18 and 36 months for their study—consists of 10 simple questions. Each question is answered with “no (0)”, “sometimes (1)”, or “yes (2)”, and then health care providers simply tally up the score. The highest score is 20; anything lower than 12 is cause for concern. Here are the 10 questions in the PDQ-1:
Does your child:
Point or gesture to show interest or get attention?
Have unusual or variable responses to sound?
Smile or make regular eye contact with others?
Respond to name when called?
Show interest in children at play?
Enjoy doing “handshake” or “peek-a-boo”?
Relate to others by babbling, gesturing, talking, or changing expressions
Use three or more words regularly and appropriately
Speak in phrases (ie, “want juice”)
Laugh when others laugh
However tempting it may be, Zahorodny advises parents not to try using this test to diagnose their kids at home. “The PDQ-1 is best administered in the context of primary care practices,” he says. “The new test has not been assessed outside the context of receiving care, so I discourage [parents to try it on their own]. If a parent has concerns about their child’s development between birth and three years, regardless of PDQ-1 score, I encourage consultation with the child’s doctor.”
But within a clinical, controlled setting, Zahorodny says the PDQ-1 is an accurate tool that can help fill a glaring gap in autism care by providing early diagnosis and putting kids on the path toward therapy as soon as possible. “Wide use of effective autism screeners is essential if we are to increase the proportion of children with autism who benefit from timely and effective early intervention.”
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