Research Summaries

Can developmental screening tools help flag speech-language delays at age 2? In a study of 7,198 children using electronic health records, lower SWYC scores—reflecting greater developmental concern— were strongly associated with speech-language delay diagnoses at the 24-month visit, with differences observed across insurance type and demographic groups.

Many young autistic children also have ADHD, which can impact the child’s experiences. However, figuring out which autistic children have ADHD can be difficult. This new paper from Duke researchers describes an approach that providers can take to identify ADHD in autistic kids. Read the full paper here.

Autism develops from many different influences during early brain development. In this article, Duke researchers Alexandra Bey, MD, PhD, Scott Soderling, PhD, and Geraldine Dawson, PhD, explain a “threshold” model: no single gene or factor causes autism on its own. Instead, they describe how many small genetic differences, together with certain environmental influences before birth, can add up and increase the likelihood that a child will develop autism. Read the full article (open access) here.

Doctors sometimes use a binary “yes or no” classification to predict a long-term diagnosis using patient records, but this model doesn’t work well when patients stop coming in for visits, leaving incomplete data.

Duke researchers created the SenseToKnow app to help spot signs of autism in children by tracking how they interact with the videos and games in the app. The app was first tested with toddlers and showed promising results. In a recent study with kids aged 3 to 8, the app showed clear differences between autistic and non-autistic children. With further testing, the app might be useful for autism detection in older children.

Attention-deficit hyperactivity disorder (ADHD) is common among autistic people. Less is known about the behavioral characteristics of children who have both conditions when they are toddlers.  A recent study led by associate professor Naomi Davis, PhD, asked caregivers to answer questions about their toddlers’ behavior, including whether they noticed signs of autism or ADHD. The children were then followed over several years. Some were diagnosed with autism only or autism plus ADHD. 

A recent Duke study explored a link between ADHD, difficulties with big emotions, and adaptive behavior – a person’s ability to perform everyday social and personal life skills - in autistic children. We found that kids with more difficulty managing big emotions also had greater difficulties with social adaptive behavior specifically.

Our team tested the accuracy of the SenseToKnow app for autism screening when used by caregivers at home on their own mobile phone or tablet. The results showed that the mobile autism screening app can be done at home and still provide a high level of accuracy for identifying autism in toddlers, comparable to the results of earlier studies in our clinic and lab. The possibilities for remote screening could lower barriers to autism screening, reduce disparities in early access to services and support, and improve children’s outcomes.

Using information from routinely collected electronic health data, Duke researchers discovered that knowing whether a child has an early history of language or developmental delay improved their ability to predict whether that child will later be diagnosed with autism.

In 2024, Duke autism researcher Jane Marryat and team compared toddlers’ scores on the Modified Checklist for Autism in Toddlers (MCHAT), which is used to screen for autism in young children, with another measure of behavioral and emotional concerns. Findings suggest that high scores on an MCHAT autism screening may indicate other behavioral concerns such as ADHD that should alert clinicians and families to additional support needs for young children.