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Utilizing two-tiered screening for early detection of autism spectrum disorder
Journal article   Open access   Peer reviewed

Utilizing two-tiered screening for early detection of autism spectrum disorder

Meena Khowaja, Diana L Robins and Lauren B Adamson
Autism : the international journal of research and practice, v 22(7), pp 881-890
Oct 2018
PMID: 28905644
url
https://doi.org/10.1177/1362361317712649View
Published, Version of Record (VoR) Open

Abstract

M-CHAT-R Autism screening STAT early detection M-CHAT
Despite advances in autism screening practices, challenges persist, including barriers to implementing universal screening in primary care and difficulty accessing services. The high false positive rate of Level 1 screening methods presents especially daunting difficulties because it increases the need for comprehensive autism evaluations. The current study explored whether two-tiered screening – combining Level 1 (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) and Level 2 (Screening Tool for Autism in Toddlers & Young Children) measures – improves the early detection of autism. This study examined a sample of 109 toddlers who screened positive on Level 1 screening and completed a Level 2 screening measure prior to a diagnostic evaluation. Results indicated that two-tiered screening reduced the false positive rate using published STAT cutoffs compared to Level 1 screening alone, although at a cost to sensitivity. However, alternative STAT scoring in the two-tiered screening improved both positive predictive value and sensitivity. Exploratory analyses were conducted, including comparison of autism symptoms and clinical profiles across screening subsamples. Recommendations regarding clinical implications of two-tiered screening and future areas of research are presented.

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33 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Psychology, Developmental
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