The Centers for Disease Control and Prevention estimate that one in 59 children have been identified with autism spectrum disorder. Diana Robins is one of the much-needed experts on autism’s frontlines.
Robins began in neuropsychology, nurturing an interest in brain-behavior relationships in autism and working with functional MRIs on neuroimaging and how brains function. She found herself “drawn to the types of applied science that have real-world impacts.”
Slowly, her focus turned toward autism screening and early detection. When autism isn’t detected early, it can lead to hindered communication skills. “Alongside the research, we were engaging in discoveries about how pediatric providers can detect autism [in patients] as young as possible,” she says.
Over the years, Robins and various researchers have created a parent-reported 20-question tool for pediatricians known as the Modified Checklist for Autism in Toddlers (M-CHAT). In a study of children under 2, the M-CHAT was able to detect autism in about 85 percent of them. Its structured questions work like a flowchart, so doctors can make a determination following an algorithm.
Previously, pediatricians employed clinical judgment and observation, which identified just 25 percent of cases. “Surveillance does many things, and it will detect many conditions,” says Robins. “But, for autism, it’s not very successful when kids are so young.”
Today, the M-CHAT has been translated into over 50 languages. It’s one of the most widely used tools worldwide for early detection of autism, which should ideally be diagnosed before a child’s fourth birthday. Robins describes the early behavioral intervention process as a “systematic, repeated teaching to push into children’s experiences what we think will help them learn.”
Studies find that 30-35 percent of children who don’t have frequent high-quality treatment won’t learn to speak fluently. For those who do undergo such treatment before the age of 4, the risk that they will lack language fluency drops to 10 percent.
In 2017, Robins received a grant for $11.4 million from the Autism Centers of Excellence to further her work. She currently serves as interim director of the A.J. Drexel Autism Institute, where she’s helping shape the organization’s priorities and its next phase. For her, that means increased collaboration on research that will “exponentially grow the impact our work can have on the field.”