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Jennifer A. Pinto-Martin, PhD, Margaret Dunkle, BA, Marian Earls, MD, Dane Fliedner, MD and Cynthia Landes, MPH, MA

Jennifer Pinto-Martin is with the University of Pennsylvania School of Nursing, Philadelphia, and the Pennsylvania Center for Autism and Developmental Disabilities Research and Epidemiology, Philadelphia. Margaret Dunkle is with the Department of Health Policy, School of Public Health and Health Services at The George Washington University, Washington, DC. Marian Earls is with Guilford Child Health, Inc., Greensboro, NC, and the Commonwealth Fund Assuring Better Child Health & Development (ABCD) Project, New York, NY. Dane Fliedner is with the Children’s Clinic, Long Beach, Calif. Cynthia Landes is with the Cedar Sinai Medical Center in Los Angeles, Calif,

Correspondence: Request for reprints should be sent to Jennifer Pinto-Martin, PhD, Professor, University of Pennsylvania School of Nursing, Director, Center for Autism and Developmental Disabilities, Research and Epidemiology, NEB Room 436, 420 Guardian Dr, Philadelphia, PA 19104 (e-mail: pinto{at}nursing.upenn.edu).

Through the use of 2-stage screening strategies, research studies have shown that autism spectrum disorders and other developmental disabilities can now be detected reliably and with greater validity and in children as young as 18 months of age. Screening and diagnostic practices in the medical and educational arena lag far behind clinical research, however, with the average patient age at time of diagnosis being 3 to 6 years.

We discuss the challenges of instituting universal developmental screening as part of pediatric care and present 2 models of existing or planned programs of early screening for autism spectrum disorder and developmental disability (1 in a community-based setting and 1 in a pediatric setting), and discuss the pros and cons of the different strategies.

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