The expression Developmental Disorder (DD) is a broad concept that includes the Autistic Spectrum Disorders (ASD). DD is defined as any deviation in neurodevelopment below -1.5 standard deviations from the mean expected for the age. It is a limitation in the cognitive or adaptive functioning that begins in early childhood and produces behaviour disturbances at home, at school or at the community, or an intellectual deficit that can show as language delay, learning, reasoning or judgement disabilities, problem solving disability or inability for abstract reasoning. Autism or ASD is a neurodevelopment disorder genetically based consisting of the impairment of two major axis of behaviour: communication and social interaction and repetitive behaviour patterns with restrictive interests.
Early detection of developmental disorders
DD are prevalent disorders in which early intervention produces improvement. We do not have tests sensitive and specific enough for screening of DD in general population at low risk. Opportunistic, longitudinal and team supervision of DD is relevant, as well as talking to parents about their concerns on the development at each occasion that the primary care professional may have.
Autistic spectrum disorders screening
Massive screening of ASD in low risk population would produce an estimated positive predictive value around 38% in our setting, with an excess of referrals to specialised services and labelling effect on the patients. It is considered more appropriated the screening in population at risk or when concerns from parents or professionals are present.
Recommendations for DD and ASD screening
|Autistic Spectrum Disorders
|Asking parents on concerns about child development in surveillance and follow up visits is suggested
||Not to do universal screening with tests like M-CHAT* is suggested
|Not to use screening tests for child development in absence of signs of DD is suggested
||Screening with tests like M-CHAT/R/F* in high risk individuals is recommended**
* M-CHAT, M-CHAT/F, M-CHAT/R, M-CHAT/R/F
**Familiar history of ASD in siblings, neurological disorders associated to ASD, prematurity, social communication disorders or repetitive behavior or alert signs of ASD.
How to cite this article: José Galbe Sánchez-Ventura. Early detection of developmental disorders. Recommendation. In Recomendaciones PrevInfad / PAPPS [on line]. Updated January 2018. [consulted MM-DD-YYYY]. Available in: http://previnfad.aepap.org//recomendacion-en/trastornos-desarrollo-enrec