Early identifications and diagnosis of autism

Research theme leader: Dr Josephine Barbaro

Researchers: Cheryl Dissanayake, Katy Unwin, Nancy Sadka, Rachel Jellett, Melissa Gilbert, Darren Hedley, Ifrah Abdullahi

Studies under this theme aim to:

  • develop evidence-based strategies and tools to identify autism in children under 3 years,
  • Inform government policy on early childhood development,
  • educate health professionals and parents/carers in how to recognise the signs of autism as early as possible, and
  • improve the outcomes of autistic children.

OTARC studies have found that when Australian children are diagnosed with autism early in life, this reduces their need for ongoing support at school age by 30%. Australian children who receive an autism diagnosis and subsequent intervention in the early and critical years (aged 18-36 months) have better school-age developmental outcomes. And yet, the average age of autism diagnosis in children remains at about 3-4 years (Clark et al., 2017; Clark et al, 2018).

An early diagnosis:

  • enables children to begin participation in specialised intervention programs at younger ages, maximising their developmental opportunities,
  • promotes greater independence and better quality of life for autistic children and their families,
  • benefits the community by significantly increasing the chances of these children participating in society.

New research – Service pathway experiences of parents seeking a diagnosis for their child

Bent, C. A., Barbaro, J., & Dissanayake, C. (2020). Parents' experiences of the service pathway to an autism diagnosis for their child: What predicts an early diagnosis in Australia? Research in Developmental Disabilities, 103. doi 10.1016/j.ridd.2020.103689

Participants included 107 parents of children on the autism spectrum who were diagnosed by 7 years of age and a smaller subgroup of 29 parents whose children were diagnosed after 7 years of age.

The online survey found that:

  1. It took 12 months and eight appointments on average to get an autism diagnosis.
  2. Parents who were advised to ‘wait and see’ had longer waiting times.
  3. Single parents reported that it took longer to receive a confirmed diagnosis.
  4. Parents of older children reported a longer time between raising concerns and diagnosis.

Read more

External Resources

Government-funded diagnosis services (for under 18s)

Autism in the early years

Support groups

Current studies


Social Attention and Communication Study-Revised (SACS-R)

Funding: Menzies Foundation; Autism CRC

Prospective identification of autism in infants, toddlers, and pre-schoolers using the Social Attention and Communication Surveillance-Revised and Preschool tools (SACS-R & SACS-PR) in Maternal and Child Health settings in Victoria.Josephine Barbaro
Lael Ridgway
Cheryl Dissanayake

Evaluation of ASDetect, a mobile application for autism

Funding: La Trobe University, School of Psychology and Public Health

The aim of this study is to determine the psychometric properties of ASDetect, a mobile application designed to enable parents and caregivers to assess their infant or toddler's likelihood for autism.Josephine Barbaro
Cheryl Dissanayake
Nancy Sadka
Lael Ridgway
Melissa Gilbert

A comparison of early development and symptoms of autistic children born preterm and full-term

Funding: La Trobe University

This study examines differences in key indicators of child development and characteristics of autism between autistic children born preterm (before 36 weeks gestation) and full-term. All children were aged 22-34 months at time of their diagnosis and were identified at high likelihood for autism in the community through the SACS and SACS-R studies.Jenny (Thuy Vi) Luu (honours graduate)
Rachel Jellett
Josephine Barbaro

ASDetectPRO training needs analysis

Funding: La Trobe University

This study examines the current autism knowledge and training needs of medical and primary health, allied health, and early childhood education professionals to inform the development of ASDetectPRO, an early autism education program and tool for professionals.Melissa Gilbert
Josephine Barbaro
Radhika Nair
Shannon Elgar (2020 honours candidate)

Maternal and child health nurse training for the early identification of autism

Funding: Victorian Government

Aims to provide professional development training for the Victorian Maternal and Child Health Workforce on the early identification of autism and the Social Attention and Communication Surveillance tool.Katherine (Kate) Gore (honours graduate)
Melissa Gilbert
Josephine Barbaro

Reducing the age of diagnosis of autism in Nepal: SACS-N

Funding: School of Psychology and Public Health, La Trobe University

The aim of this study is to implement social attention and communication surveillance of young children by female health nurse volunteers in order reduce the age of autism diagnosis in Nepal.Rena Shrestra
Cheryl Dissanayake
Josephine Barbaro

Early identification of ASD in Japan: Statutory infant health checkups and early screening tools

Funding: School of Psychology and Public Health, La Trobe University

The study aim is to enable earlier identification of autism within the statutory health check-ups for children in Japan.Hiroko Kawashima (PhD candidate)
Cheryl Dissanayake
Darren Hedley
Emiko Kezuka

Prospective identification of ASD in infants and toddlers: Social Attention and Communication Surveillance

Funding: Autism CRC

The aim of this study is to promote the early identification of children with autism by community service providers so that they may receive an early diagnosis. The study was undertaken in Victoria and Tasmania.Cheryl Dissanayake
Josephine Barbaro
Lyndsay Quarmby (University of Tasmania)
Tony Barnett (University of Tasmania)
Nancy Sadka
The SACS team
Brief Autism Detection in Early Childhood (BADEC)The aim of this study is to test the predictive validity of brief ASD Level 2 screen in a US sample.Darren Hedley
Rose Nevill (University of Virginia)
Robyn Young (Flinders University)
Micah Mazurek (University of Virginia)
Fei Nah (Singapore National University)
The production and validation of a Sensory Observation Autism Rating scale (SOAR) to map autism-specific sensory behaviours and improve early diagnosisThis study aims to create and validate a Sensory Observation Autism Rating scale (SOAR) in order to identify autism-specific sensory behaviours in young children (0-3 years).Katy Unwin
Josephine Barbaro
Alison Lane (University of Newcastle)

Developmental surveillance for Autism Spectrum Disorder (ASD) in early childhood education settings

Funding: Autism CRC

Early identification of autism in infants and toddlers in Early Childhood Education settings using the Social Attention and Communication Surveillance-Revised (SACS-R) tool.Beth Mozolic-Staunton
Michelle Donelly
Jacqui Yoxall (Southern Cross University)
Josephine Barbaro

Examining the association between parental cultural and ethnic background and the diagnosis of autism in 12—42-month-old children

Funding: La Trobe University

This study investigates the association between parental cultural and ethnic background and the diagnosis of autism in 12–42-month-old children, identified via the early years program at OTARC.Jessica Scaletti (2020 honours candidate)
Ifrah Abdullahi
Josephine Barbaro
Nancy Sadka

State-wide implementation of the Social Attention and Communication Surveillance-Revised (SACS-R) in Tasmania

Funding: Autism CRC

The SACS-R is an autism developmental surveillance tool that has been utilised by Child Health and Parenting Service (CHaPS) nurses in Tasmania since 2016. This practice change was evaluated with the parent and their child at the centre of the process through the use of an innovative methodology, Design Thinking (DT). DT utilises a collaborative approach to aid understanding, development and evaluation of the needs of the stakeholders and their responses regarding the implementation of the SACS-R project.Josephine Barbaro
Nancy Sadka
Ali Morse
Lyndsay Quarmby
Tony Barnett (University of Tasmania)

A multistate trial of an early surveillance program for autism within general practices in Australia

Funding: Autism CRC

A cluster randomised controlled trial comparing usual care with an enhanced early autism surveillance protocol in general practice for children aged 18 to 24 months.Josephine Barbaro
Melissa Gillbert
Ifrah Abdullahi
Radhika Nair
Katy Unwin
& the UNSW team
Valsamma Eapen
Anne Masi
Antonio Mendozza Diaz
Aline Smith
Iqbal Hasan


Clark, M. L., Barbaro, J., & Dissanayake, C. (2017). Continuity and Change in Cognition and Autism Severity from Toddlerhood to School Age. Journal of Autism and Developmental Disorders, 47, 328-339. doi: 10.1007/s10803-016-2954-7

Clark, M. L., Vinen, Z., Barbaro, J., & Dissanayake, C. (2018). School age outcomes of children diagnosed early and later with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 48, 92-102. doi: 10.1007/s10803-017-3414-8