Screening for autism: agreement with diagnosis

Area of Science:

• Developmental psychology
• Pediatric diagnostics
• Autism spectrum disorder research

Background:

• Early identification of autism spectrum disorders (ASD) is crucial for timely intervention.
• Screening tools such as the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ) are commonly used.
• The validity of these parent-completed questionnaires in identifying at-risk children requires examination.

Purpose of the Study:

• To evaluate the diagnostic validity of the M-CHAT and SCQ in a clinical setting.
• To assess the sensitivity and specificity of these screening tools for autism spectrum disorders.
• To understand factors influencing the performance of screening measures.

Main Methods:

• Parents of children aged 2-6 years completed the M-CHAT or SCQ before a diagnostic assessment at a tertiary autism clinic.
• The M-CHAT was administered to 84 parents of 2- to 3-year-olds.
• The SCQ was administered to 94 parents of 4- to 6-year-olds.

Main Results:

• Both M-CHAT and SCQ demonstrated higher sensitivity than specificity, with positive predictive values ranging from 0.63 to 0.68.
• A notable proportion of false negatives (children with autism missed by screening) were observed, particularly among higher-functioning individuals.
• Screening results were unexpectedly better for parents who spoke English as a second language.

Conclusions:

• The M-CHAT and SCQ are valuable components of comprehensive surveillance programs for identifying children needing further autism assessment.
• These tools, at their current stage, should not be solely relied upon to exclude the possibility of autism.
• Further research is needed to refine screening tools and improve their accuracy in diverse populations.