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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Validation of the Electronic Modified Checklist for Autism in Toddlers, Revised with Follow-Up: A Nonrandomized Controlled Trial
The Journal of pediatrics, v 262, 113343
01 Feb 2023
PMID: 36736890
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To examine the classification rates and screening properties, including sensitivity and specificity, of the web-based Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) compared with paper-phone administration, and to determine the extent to which electronic M-CHAT-R/F streamlines screening, increases screening fidelity, increases diagnostic evaluation participation, and decreases waiting time from screening to evaluation compared with paper-phone modality.
Primary-care practices in urban and suburban settings administered either the web-based or paper-phone M-CHAT-R/F using a prospective nonrandomized control design. Toddlers (n=17,900) were screened between 2009 and 2016 at routine well-child check-ups. Toddlers who screened at risk on the M-CHAT-R/F were invited to complete diagnostic evaluations; 176 children were diagnosed with autism. Chi-square, Fisher's exact, and t-tests, as well as regression and screening properties were used to compare outcome distributions, screening properties, and implementation by modality.
Classification rates of the initial M-CHAT-R into low, medium, and high risk were significantly different across modalities with very small effect sizes. Sensitivity and specificity were high across both modalities. For children in the medium-risk range, the web-based modality had a higher rate of predicting risk for autism after Follow-Up compared with the paper-phone modality, and the web eliminated delay between initial screen and Follow-Up. The web-based modality showed increased screening fidelity, no data loss, and similar rates of evaluation attendance and time to evaluation from Follow-Up administration.
Web-based M-CHAT-R/F is a valid tool for universal autism screening. Systems-level decisions should balance the increased feasibility of the electronic administration with the increase in Follow-Up accuracy is provided by skilled clinician interview.
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Details
- Title
- Validation of the Electronic Modified Checklist for Autism in Toddlers, Revised with Follow-Up: A Nonrandomized Controlled Trial
- Creators
- Shana M Attar - University of WashingtonLauren E Bradstreet - Kennedy Krieger InstituteRiane K Ramsey - The Ohio State UniversityKiva Kelly - Drexel UniversityDiana L Robins - Drexel University
- Publication Details
- The Journal of pediatrics, v 262, 113343
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- Eunice Kennedy Shriver National Institute for Child Health and Human Development; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) R01HD039961 / Autism Speaks Targeted Award
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:001057824400001
- Scopus ID
- 2-s2.0-85167457182
- Other Identifier
- 991019937412404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics