SACS-R can identify autism in very young children, opening up support avenues earlier
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SACS-R can identify autism in very young children, opening up support avenues earlier

by Freya Lucas

March 17, 2022

A powerful screening tool developed by La Trobe University, known as The Social Attention and Communication Surveillance-Revised (SACS-R), can predict the likelihood of infants and toddlers aged 12 to 24 months developing autism by three and a half years with up to 83 per cent accuracy. 


The accuracy of autism screening tools used in other parts of the world is very limited, including the well-known M-CHAT, which has an accuracy level of just six per cent when used in a community-based population, making the new tool a remarkable asset to those working with young children in a clinical setting. 


Developed over 15 years by Associate Professor Josephine Barbaro, the tool is used to identify a set of behaviours that are characteristic of children on the spectrum from as young as 11 months old, including infrequent or inconsistent use of:


  • gestures, like waving and pointing at objects
  • response to name being called
  • eye contact
  • imitation or copying others’ activities
  • sharing interest with others
  • pretend play.


“Parents are often told to ‘wait and see’ when raising queries about their child’s development. This means the average age of diagnosis is around four to five, and opportunities for early supports have been missed,” said Associate Professor Barbaro. 


When used alongside a SACS-Preschool check, 96 per cent of children on the autism spectrum were identified by their 3.5 year health check. A five-year study of over 13,500 Victorian children was published recently in JAMA Open, finding the SACS-R to be extremely accurate in identifying very young children on the autism spectrum. 


The research, Associate Professor Barbaro said, points to the critical need for the SACS-R and SACS-Preschool to be rolled out across Australia and the world, as part of regular infant health checks.


“Putting this extremely effective tool in the hands of a trained primary health professional, so that during their routine health checks they are also monitoring for autism, makes a huge difference to early diagnosis,” she added.


“Not only is SACS-R the world’s most effective screening tool, unlike many it can be used within the community on large populations, enabling early identification of very young children across the board.” 


Obtaining an early diagnosis of autism is critical, as it leads to earlier access to affirming supports and services, she explained, improving developmental outcomes, increasing participation in schooling, and allowing children to understand their needs and identity from a young age.


Every Victorian child attending a routine health check at 12, 18 and 24 months is already monitored with the SACS-R tool, after the Victorian Government funded state-wide training for maternal and child health nurses in 2019.


The added SACS-Preschool tool can be used at the 3.5-year health check to increase the effectiveness of the identification process – though training for that is not currently funded in Victoria.


La Trobe Vice-Chancellor Professor John Dewar AO described the screening tool as an excellent example of high-impact research that can make a tangible difference to people’s lives.


“Early autism identification using this tool has already changed the lives of thousands of children and their families around the world,” Professor Dewar said, noting that the new research will likely lead to even more countries adopting the tool and embedding screening programs into their health systems.


SACS-R is now used state-wide in Victoria and Tasmania, and training has been completed in New South Wales, Queensland, and South Australia.


Health professionals in ten other countries around the world – including China, Singapore, Poland, Japan, New Zealand, Nepal and Bangladesh – have also been trained in using the tool.


More information on the Associate Professor’s research into autism detection and diagnosis can be found here.

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