Screening is not diagnosis: where early autism identification fails in the 0-5 clinical pathway

This article examines early autism identification in children aged 0-5 years not as a problem of a single screening tool’s accuracy, but as a problem of breakdowns across the full clinical pathway from first concern to assessment and support. Failure may occur at multiple stages: parental concerns may not trigger timely clinical escalation, a positive screening result may not translate into referral, referral may not secure rapid multidisciplinary assessment, and support may be delayed while families wait for diagnostic certainty. The article argues that the clinical priority should shift from searching for a "perfect test" to building a faster and more coherent pathway from concern to action.