Abstract
Background: The Quantitative Checklist for Autism in Toddlers (Q-CHAT) is parent-report screening questionnaire for detecting threshold and sub-threshold autistic features in toddlers. The Q-CHAT is a dimensional measure normally distributed in the general population sample and is able to differentiate between a group of children with a diagnosis of autism and unselected toddlers. Objectives: We aim to investigate the psychometric properties, score distribution, and external validity of the Q-CHAT in an Italian clinical sample of young children with autism versus children with developmental delay and typically developing children. Method: N = 126 typically developing children (TD), n = 139 children with autism, and n = 50 children presenting developmental delay (DD) were administered the Q-CHAT. Standardized measures of cognitive functions, language, and behaviors were also obtained. Results: The Q-CHAT scores were normally distributed and demonstrated adequate internal consistency and good item to total score correlations. The mean Q-CHAT score in the autism group was significantly higher than those found in the DD sample and TD children. No difference on the mean Q-CHAT score between DD and TD children was found. The accuracy of the Q-CHAT to discriminate between autism and TD was very good. Two different cut-points (27 and 31, respectively) maximized sensitivity and specificity for autism versus TD and DD, respectively. Finally, higher Q-CHAT scores were correlated with lower language and social communication skills. Conclusions: In clinical settings, the Q-CHAT demonstrated good psychometric properties and external validity to discriminate autism children not just from children with typical development but also from children with developmental delay.
Highlights
Autism spectrum conditions are a neurodevelopmental condition that significantly impairs social communication and includes unusually narrow interests and difficulties adjusting to unexpected change [1]
Neither a main effect of region nor a region by group interaction was found for the Q-Checklist for Autism in Toddlers (CHAT) scores; all the relevant analyses were conducted on the whole sample
The autism group had more males than females compared to the Developmental Delay (DD) and typically developing children (TD) groups (p < 0.001 for both comparisons), while no difference in gender distribution was found between DD and TD children
Summary
Autism spectrum conditions (autism) are a neurodevelopmental condition that significantly impairs social communication and includes unusually narrow interests and difficulties adjusting to unexpected change [1]. Early intervention is possible only if children at risk can be detected accurately through autism-specific screenings by the age of 18–24 months and immediately referred for diagnostic assessment. BISCUIT-Part 1 total scores in the autism group were significantly higher than those reported in the control group with developmental conditions In another preliminary study on the Quantitative Checklist for Autism in Toddlers (Q-CHAT), Allison et al [20] examined the clinical validity of the Q-CHAT as a dimensional measure of threshold and sub-threshold autistic features and found that the Q-CHAT was normally distributed in the general population sample and was able to differentiate between a group of children with a diagnosis of autism and unselected toddlers. The Q-CHAT is a dimensional measure normally distributed in the general population sample and is able to differentiate between a group of children with a diagnosis of autism and unselected toddlers
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