Checklist to Identify Autism Earlier

A simple 24-item checklist developed by researchers at the University of California, San Diego (UCSD), in La Jolla may prove to be an important screening tool for detecting early signs of autism spectrum disorders (ASDs), and language and developmental delays in children as young as 1 year old.

The checklist titled the Communication and Symbolic Scales Development Profile Infant-Toddler Checklist is completed by parents and guardians while they are in the doctor’s waiting room. It assesses a child’s ability to communicate using age appropriate sounds, eye contact, gazes and gestures.  The hope is that by discovering the early signs of ASDs, the child can be directed toward early intervention treatment. Currently, the Centers for Disease Control and Prevention (CDC) reports that the average age of ASD diagnosis and treatment is around 5.7 years old, though most of those children show signs of developmental problems before age 3.

Karen Pierce, PhD and lead author of the study says that, “Identifying language and developmental delays in babies may also help scientists uncover the underlying neurological processes of autism, paving the way for more effective treatments.” (

“Most of the studies on autism are on adolescents and adults,” says Pierce who is an assistant professor of neuroscience at the University of California San Diego in La Jolla. (

“Some (are) on children, but very few people have the ability to study autism in babies, because we can’t diagnose it until 3 or 4 years. How in the world are we going to discover the causes if we’re studying brains that have had a life time of living with autism, and (have) a host of compensatory mechanisms? (

At the end of a two-year study conducted by 137 pediatricians in San Diego County, 32 of the 10,479 children screened were found to have ASD. According to the authors of the study, this number compares with what one would expect from a 12-month-old baby.  (Nordqvist)

An additional 96 children were diagnosed with some other disability, and 46 children were “false positives,” which means they had no developmental delays. The study appears to have a 75% accuracy diagnosis, when children identified with having developmental and language delay, or some other form of delay were included. (Nordqvist)

Children found to have developmental and language delays, and the children diagnosed with ASD went on to have behavioral therapy at approximately 17 months old – compared to the current national average of 5.7 years. (Nordqvist)

As far as wide spread use of the questionnaire as a screening tool, Pierce says, “In the context of a virtual lack of universal screening at 12 months, this program is one that could be adopted by any pediatric office, at virtually no cost, and aid in the identification of children with true developmental delays.” However the study’s authors point out that more studies are needed to redefine the screening tool, monitor the children for longer, and to determine barriers present in treatment follow-up. (Nordqvist)

“Questionnaire May Help Predict Autism at 1 Year.” Cable News Network, 04 28 2011. Web. 3 May 2011.

Christian Nordqvist, . “Checklist May Help Identify Autism Earlier On In Life.” Medical News Today. Medical News Today, 05 01 2011. Web. 3 May 2011.

The Questionnaire

Below are the questions asked in the checklist for the parent or caregiver to complete. It is called the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist.”

Emotion and Eye Gaze

  • Do you know when your child is happy and when your child is upset?
  • When your child plays with toys, does he/she look at you to see if you are watching?
  • Does your child smile or laugh while looking at you?
  • When you look at and point to a toy across the room, does your child look at it?


  • Does your child let you know that he/she needs help or wants an object out of reach?
  • When you are not paying attention to your child, does he/she try to get your attention?
  • Does your child do things just to get you to laugh?
  • Does your child try to get you to notice interesting objects – just to get you to look at the objects, not to get you to do anything with them?


  • Does your child pick up objects and give them to you?
  • Does your child show objects to you without giving you the object?
  • Does your child wave to greet people?
  • Does your child point to objects?
  • Does your child nod his/her head to indicate yes?


  • Does your child use sounds or words to get attention or help?
  • Does your child string sounds together, such as uh, oh, mama, gaga, bye bye, bada?
  • About how many of the following consonant sounds does your child use: ma, na, ba, da, ga, wa, la, ya, sa, sha?


  • When you call your child’s name, does he/she respond by looking or turning toward you?
  • About how many different words or phrases does your child understand without gestures? E.g., if you say “where’s your tummy,” “where’s Daddy”, “give me the ball,” or “come here” without showing or pointing, your child will respond appropriately.

Object use

  • Does your child show interest in playing with a variety of objects?
  • About how many of the following objects does your child use appropriately: cup, bottle, bowl, spoon, comb or brush, toothbrush, washcloth, ball, toy vehicle, toy telephone?
  • About how many blocks or rings does your child stack?
  • Does your child pretend to play with toys (e.g. feed a stuffed animal, put a doll to sleep, put an animal figure in a vehicle)?

Do you have any concerns about your child’s development (If “yes”, describe on back).

“Communication and Symbolic Behavioral Scales Developmental Profile Infant-Toddler Checklist”
By Amy M. Wetherby, PhD, CCC-SLP, and Barry M. Prizant, PhD, CCC-SLP