Abstract
To determine the best discriminative items for identifying young children with autism spectrum disorders (ASD), we conducted a secondary analysis using longitudinal cohort data that included the Japanese version of the 23-item modified checklist for autism in toddlers (M-CHAT-JV). M-CHAT-JV data at 18 months of age and diagnostic information evaluated at age 3 or later from 1851 Japanese children was used to isolate six highly discriminative items. Using data from two different community samples (n = 1851, n = 665) these items were shown to have comparable psychometric values with those of the full version. Our results suggest that these items might work as a short form screener for early identification of ASD in primary care settings where there are time constraints on screening.
Highlights
A growing body of research data supports the idea that community-based active surveillance for early signs of autism spectrum disorders (ASDs), complemented by autism-specific screening tools, may help reduce the time between the initial emergence of ASD symptoms and referral for specialized assessment (Robins 2008; Zwaigenbaum et al 2009)
Our results suggest that these items might work as a short form screener for early identification of ASD in primary care settings where there are time constraints on screening
The M-CHAT/F, which has been recommended based on the findings from studies targeting low-risk children (Chlebowski et al 2013; Kleinman et al 2008; Pandey et al 2008; Robins 2008), confirms whether positive screens still fail on certain items, resulting in a reduced number of false positive (FP) cases and improving the positive predictive value (PPV)
Summary
A growing body of research data supports the idea that community-based active surveillance for early signs of autism spectrum disorders (ASDs), complemented by autism-specific screening tools, may help reduce the time between the initial emergence of ASD symptoms and referral for specialized assessment (Robins 2008; Zwaigenbaum et al 2009). The modified checklist for autism in toddlers (MCHAT) (Robins et al 2001) is a 23-item parent-report instrument for children aged 16–30 months. It is one element in a ‘‘two-step’’ screening procedure that consists of the initial administration of the M-CHAT screening questionnaire (step 1) and the M-CHAT Follow-Up Interview (M-CHAT/F) (www.mchatscreen.com/Official_M-CHAT_ Website_files/M-CHAT_FollowUp.pdf) (step 2). The M-CHAT/F, which has been recommended based on the findings from studies targeting low-risk children (Chlebowski et al 2013; Kleinman et al 2008; Pandey et al 2008; Robins 2008), confirms whether positive screens still fail on certain items, resulting in a reduced number of false positive (FP) cases and improving the positive predictive value (PPV). A recent large-scale study reported that M-CHAT screening for children aged 18–24 months in primary care settings resulted in a PPV of 0.54 for identifying ASD, and 0.98 for identifying any developmental concerns (Chlebowski et al 2013)
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