November Week 1


1. Recognition of Autism Before Age 2 Years. Chris Plauché Johnson.Pediatrics in Review 2008;29;86.

2. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Pediatrics. 2006 Jul;118(1):405-20.


A 15 month old boy (Billy) comes to your office for his WCC with his mother. He has been healthy, is growing well, has no significant past medical history, and is about to start daycare this winter. His mother is concerned because her niece has recently been diagnosed with autism and she is worried that Billy might have it too.

1.) At what age can autism be diagnosed?
2.) How are delays in Autism Spectrum Disorders different from Global Developmental Delays?
3.) What is involved with developmental surveillance and at which visits do you perform surveillance?

Due to this mother’s concerns, you start to do some more investigation. A developmental history reveals that at his 12 month visit, Billy had just started taking independent steps, could drink from a cup, follow simple commands, and had one understandable word.

4.) What are some of the red flags for ASD in language development that you should look for?

You ask Billy’s mom to describe his favorite types of toys and types of play. Mom tells you that he enjoys roughhousing and building towers with bricks.

5.) What are some of the differences in the types of toys and play that children with ASDs prefer? What specific type of play do children with autism rarely demonstrate?
6.) What is Joint Attention? How might you test for Joint Attention in your office? How is this helpful in identifying children at risk for having ASD?

After completing a thorough history, observation, and physical exam, you decide to administer an autism specific screening tool (ie: M-CHAT) in your office.

7.) When does the AAP recommend specific autism screening?
8.) If there were no concerning results on the screening tool, what would you tell his mother? When should you make a referral and which referrals would you make?

Case by Dr. Janell Harro