When to Screen

There is no single right answer to the question, “When should I use the validated screening tool?” Recent AAP guidelines suggest using a validated tool at the 9, 18, and 30 month visits, or at 24 months if there is no 30 month visit. An autism-specific tool is recommended at 18 months.

At BCH, we chose to screen at every well child visit from 6 months through 8 years for several reasons:

  • Our high (30%) no-show rate- we didn’t want to skip the screen for too long.
  • Many of our patients come with family members who are not parents, so handing out the survey at every well child visit maximizes the possibility that the most familiar caregiver will complete it at some point.
  • Our patient population is very large and asking the front desk to give out the tool only at certain visits was too cumbersome.
  • Our computer system identifies patients by visit type (well child check vs. urgent care vs. follow up) making it easy for front desk staff to know who gets it.
  • Most residents only have clinic once a week, and often see infants; we wanted them to master a single tool rather than try to learn several age-specific forms.

So far, this decision has worked well for us.  You may choose a different schedule for reasons specific to your practice.