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Validation of the Electronic Modified Checklist for Autism in Toddlers, Revised with Follow-Up: A Nonrandomized Controlled Trial
Journal article   Open access   Peer reviewed

Validation of the Electronic Modified Checklist for Autism in Toddlers, Revised with Follow-Up: A Nonrandomized Controlled Trial

Shana M Attar, Lauren E Bradstreet, Riane K Ramsey, Kiva Kelly and Diana L Robins
The Journal of pediatrics, v 262, 113343
01 Feb 2023
DOI: https://doi.org/10.1016/j.jpeds.2022.11.044
PMID: 36736890
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390646View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

ASD screening digital health universal screening implementation diagnosis Technology Autism
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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12 Record Views
7 citations in Web of Science
8 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Pediatrics
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