Public health. Hygiene-occupational medicine Public health. Hygiene General aspects Psychology. Psychoanalysis. Psychiatry Infantile autism Prevention and actions Psychopathology. Psychiatry Developmental disorders Biological and medical sciences Medical sciences Child clinical studies Psychiatry
OBJECTIVE: This study validates the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), a screening tool for low-risk toddlers, and demonstrates improved utility compared with the original M-CHAT.
METHODS: Toddlers (N = 16 071) were screened during 18- and 24-month well-child care visits in metropolitan Atlanta and Connecticut. Parents of toddlers at risk on M-CHAT-R completed follow-up; those who continued to show risk were evaluated.
RESULTS: The reliability and validity of the M-CHAT-R/F were demonstrated, and optimal scoring was determined by using receiver operating characteristic curves. Children whose total score was >= 3 initially and >= 2 after follow-up had a 47.5% risk of being diagnosed with autism spectrum disorder (ASD; confidence interval [95% CI]: 0.41-0.54) and a 94.6% risk of any developmental delay or concern (95% CI: 0.92-0.98). Total score was more effective than alternative scores. An algorithm based on 3 risk levels is recommended to maximize clinical utility and to reduce age of diagnosis and onset of early intervention. The M-CHAT-R detects ASD at a higher rate compared with the M-CHAT while also reducing the number of children needing the follow-up. Children in the current study were diagnosed 2 years younger than the national median age of diagnosis.
CONCLUSIONS: The M-CHAT-R/F detects many cases of ASD in toddlers; physicians using the 2-stage screener can be confident that most screen-positive cases warrant evaluation and referral for early intervention. Widespread implementation of universal screening can lower the age of ASD diagnosis by 2 years compared with recent surveillance findings, increasing time available for early intervention.
Validation of the Modified Checklist for Autism in Toddlers, Revised With Follow-up (M-CHAT-R/F)
Creators
Diana L ROBINS - Georgia State University
Karis CASAGRANDE - Georgia State University
Marianne BARTON - University of Connecticut
Chi-Ming A CHEN - University of Connecticut
Thyde DUMONT-MATHIEU - University of Connecticut
Deborah FEIN - University of Connecticut
Publication Details
Pediatrics (Evanston), v 133(1), pp 37-45
Publisher
American Academy of Pediatrics; Elk Grove Village, IL
Number of pages
9
Grant note
and Human Development grant R01HD039961 / Eunice Kennedy Shriver National Institute of 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)
National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
R01HD039961 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & 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)
Resource Type
Journal article
Language
English
Academic Unit
Psychological and Brain Sciences (Psychology); A.J. Drexel Autism Institute
Web of Science ID
WOS:000329168400042
Scopus ID
2-s2.0-84891819012
Other Identifier
991014877776804721
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