Abstract
Autism spectrum disorder (ASD) affects 1/68 children. The American Academy of Pediatrics recommends screening all toddlers for ASD between the ages 18 to 24 months using a standardized test. Toddlers in Israel undergo health visits
including general developmental screening (GDS), based on performance of several milestones at each age. While GDS detects developmental problems, the decision to refer is inconsistent. So far, the effectiveness of the test has not been
determined to identify ADS.
Objective
This study assesses the test performance of ASD screening using the modified checklist for autism in toddlers (MCHAT) compared to GDS.
Methods
1,600 toddlers from maternal child health centers (MCHC) in southern Israel were screened with GDS and MCHAT. Of these 50 children had positive results on the M-CHAT. Another 150 infants with non-positive MCHAT results were randomly selected as controls. Results of GDS for all these 200 children were de-identified and evaluated by 11 nurses who were asked to decide whether to refer them for further ASD evaluation or to continue follow-up at MCHC. Positive GDS result was determined if 6 nurses decided about the referral option.
Results
The degree of agreement between the nurses evaluation and the MCHAT was 52% (Kappa; p < 0.001). Of the 1600 children, seven were found positive in MCHAT and diagnosed with ASD compared to 5 children were found positive in GDS. MCHAT performed better in detecting children with ASD than the nurses evaluation of the GDS with 70% sensitivity, and 98.22% specificity compared to 50% sensitivity, and 96.63% specificity for MCHAT and GDS respectively. GDS showed slightly better performance in identifying children with general
developmental problems.Conclusions
MCHAT performs better in detecting children with ASD than GDS.
including general developmental screening (GDS), based on performance of several milestones at each age. While GDS detects developmental problems, the decision to refer is inconsistent. So far, the effectiveness of the test has not been
determined to identify ADS.
Objective
This study assesses the test performance of ASD screening using the modified checklist for autism in toddlers (MCHAT) compared to GDS.
Methods
1,600 toddlers from maternal child health centers (MCHC) in southern Israel were screened with GDS and MCHAT. Of these 50 children had positive results on the M-CHAT. Another 150 infants with non-positive MCHAT results were randomly selected as controls. Results of GDS for all these 200 children were de-identified and evaluated by 11 nurses who were asked to decide whether to refer them for further ASD evaluation or to continue follow-up at MCHC. Positive GDS result was determined if 6 nurses decided about the referral option.
Results
The degree of agreement between the nurses evaluation and the MCHAT was 52% (Kappa; p < 0.001). Of the 1600 children, seven were found positive in MCHAT and diagnosed with ASD compared to 5 children were found positive in GDS. MCHAT performed better in detecting children with ASD than the nurses evaluation of the GDS with 70% sensitivity, and 98.22% specificity compared to 50% sensitivity, and 96.63% specificity for MCHAT and GDS respectively. GDS showed slightly better performance in identifying children with general
developmental problems.Conclusions
MCHAT performs better in detecting children with ASD than GDS.
| Original language | English |
|---|---|
| Journal | European Journal of Public Health |
| Volume | 27 |
| Issue number | suppl 3 |
| DOIs | |
| State | Published - 20 Oct 2017 |