Paeds · growth-development-and-behaviour
Social communication concerns and autism recognition
Also known as Autism recognition · Autism red flags · Social communication delay · M-CHAT autism screen · Early autism identification
Fellowship approach to recognising social communication concerns and autism risk from infancy through school age: red flags, differential diagnosis, autism-specific screening limits, early referral and family counselling without replacing full ASD diagnostic management.
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Target exams
Red flags
- Loss of previously acquired language or social skills
- No babbling, pointing or social response in the expected age window
- Strong caregiver concern for autism even if a screen is incomplete
- Acute encephalopathy or rapid skill loss — emergency pathway, not routine wait-and-see
- Suspected severe neglect with stalled social development
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Developmental and behavioural paediatrics foundations
- Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
- Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 10: Clinical assessment and management – developmental and behavioural paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
- Clinical Applications
- Long Cases
- Short Cases
- 2. Professional skills and knowledge: Communication
- 4. Professional skills and knowledge: Patient management
- Neurodevelopment and Neurodisability
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- Development
- History
- Communication
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 5: Mental and Behavioral Health
- General Pediatrics EPA 10: Leading Interprofessional Teams to Provide Collaborative, Family-Centered Care
- Patient Care 4: Clinical Reasoning
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Medical Expert
- Pediatrics: Transition to Discipline EPA #1 — Performing and presenting a basic history and physical examination
- Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
Recognition vs diagnosis
This page owns
Sibling ASD topic owns
These distinctions keep recognition actionable without inventing a full diagnostic chapter here. [1] [3]
Overview & Definition
Parents often notice first: “He does not look when I call,” “She does not point,” or “He was saying words and stopped.” Social communication concern is a clinical problem representation, not a diagnosis. Autism spectrum disorder (ASD) is a neurodevelopmental diagnosis defined by persistent deficits in social communication and interaction plus restricted, repetitive patterns of behaviour, interests or activities, with onset in the early developmental period and functional impact. Your first job is recognition and timely pathway entry — not promising a label from a checklist. [1]
Surveillance is continuous: ask, watch, document. Autism-specific screening uses a validated tool at key ages or on concern. Diagnostic evaluation is the specialist or multidisciplinary process that can establish ASD and open formal supports. This page owns the recognition layer; general developmental surveillance tools and full ASD management are cross-linked rather than duplicated. [1] [3]
References10ShowHide
- [1]Hyman SL Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020.PMID 31843864
- [2]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
- [3]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [4]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
- [5]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
- [6]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
- [7]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428
- [8]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [9]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
- [10]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088