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Follow up of children who screened positive for autism at the age of 2.5

Participants: Anne-Katrin Kantzer, Bibbi Hagberg, Birgitta Spjut, Elisabeth Fernell, Christopher Gillberg & Carmela Miniscalco.

Background: Since 2009, children in Gothenburg are screened for autism when participating in their regular health check-up at the age of 2.5 years at the Child Health Centers (CHC). If they screen positive, they are referred to the Child Neuropsychiatry Clinic (CNC) for further investigation. The children’s development is followed continuously.

Metod: From 2009 to 2011, a total of 129 children under four years of age with suspected ASD after screening at the CHC in Gothenburg were referred to the CNC for a more in-depth ASD assessment. The assessments at the CNC were performed by a multi-professional, experienced team. This assessment included a broad neurodevelopmental examination, structured interviews ((Diagnostic Interview for Social and COmmunication disorders, DISCO), a cognitive test (Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), Griffiths’ test or Merrill-Palmer Revised Scales of Development test), evaluations of the child’s adaptive functioning (Vineland Adaptive Behavior Scales, VABS), structured observation (Autism Diagnostic Observation Schedule, ADOS), and speech and language assessment. The children were followed using the same examination methods two years later, and will be followed further up into school age.

Resultat: Of 129 children participating in the first assessment (time 1, T1), 100 met DSM-IV criteria for autism spectrum disorder (ASD), with 69 of these meeting criteria for Autistic Disorder (AD) and 31 for Pervasive Developmental Disorder, Not Otherwise Specified (PDDNOS). 29 children did not meet full DSM-IV criteria for ASD, but had marked autistic traits (AT), other ESSENCE related symptoms or both. Two years later (time 2, T2), 96 of the children participated in a follow up investigation. 76 of them had ASD at T1 och 20 had other ESSENCE related symptoms. 93% of the children with an ASD diagnosis at T1 had an ASD diagnosis two years later. 40% of those who had screened positive for ASD but who were not given an ASD diagnosis at T1, met criteria for ASD two years later. 71% of ASD diagnoses and 79% of specific AD diagnoses were stable from T1 to T2. All children with Non-ASD ESSENCE at T1 still had ESSENCE problems including autistic features at T2. Almost all the children with ASD also had non-ASD ESSENCE problems at T2.

The risk of “over-diagnosis” of ESSENCE/ASD problems by screening for ASD at 2.5 years appears to be minimal, if at all existent. Children with autism almost always have other ESSENCE related problems as well.


Kantzer, A.K., Hagberg, B., Spjut Jansson, B., Fernell, E., Gillberg, C., & Miniscalco, C. Young children who screen positive for autism: stability, change and “comorbidity” over two years, submitted

Kantzer, A.K., Fernell, E., Gillberg, C., & Miniscalco, C. (2013). Autism in community preschoolers: Developmental profiles. Research in Developmental Disabilities, 34, 2900-2908.


Page Manager: Anna Spyrou|Last update: 5/25/2016

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