Primary healthcare use of the modified checklist for autism in toddlers revised with follow-up in Portugal

Abstract

BackgroundThe Portuguese National Programme for Child and Adolescent Health recommends systematic screening for autism spectrum disorder (ASD) using the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R). If moderate risk is identified, the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) should be used. We evaluated the knowledge and use of the M-CHAT-R and M-CHAT-R/F in primary healthcare settings to reinforce the importance of these scales. MethodIn this descriptive cross-sectional study, primary care physicians were surveyed about their knowledge of both the M-CHAT-R and M-CHAT-R/F and how often they used them. The survey also included items about the necessity of training in the utilization of these scales and their integration into digital work platforms. Data were analyzed using Statistical Package for the Social Sciences software. ResultsOf 250 participants, 76% (N = 190) were acquainted with the M-CHAT-R; however, only 21% (N = 52) applied it consistently. Additionally, 39% (N = 98) of the participants used it when they suspected ASD. The main reasons for not applying the scale were limited time, lack of experience with the M-CHAT-R, and forgetfulness. Regarding the M-CHAT-R/F, only 31% (N = 77) knew the scale, which was the main reason for not using it, and 45% (N = 113) reported that they referred to a neurodevelopmental pediatrician when ASD was suspected, even if the M-CHAT-R/F had not been applied. ConclusionsDespite the recommendations, the M-CHAT-R/F is not routinely used in primary care. Professionals should reinforce their training for the correct and systematic application of this screening scale.