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Use of the Screening Tool for Autism in Two-Year-Olds (STAT) for children under 24 months: an exploratory study
Wendy L Stone1, Caitlin R McMahon, Lynnette M Henderson
1Vanderbilt University, USA. wendy.stone@vanderbilt.edu
Insights
The Screening Tool for Autism in Two-Year-Olds (STAT) effectively identifies autism in toddlers under 24 months. Optimal screening performance was observed in children aged 14 months and older.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Autism Spectrum Disorder Research
Background:
- Early detection of autism spectrum disorder (ASD) is crucial for timely intervention.
- The Screening Tool for Autism in Two-Year-Olds (STAT) is designed to assess social-communicative behaviors.
- Limited data exists on the STAT's efficacy in children younger than 24 months.
Purpose of the Study:
- To evaluate the psychometric properties of the STAT in children under 24 months.
- To determine an optimal cut-off score for the STAT in this age group.
- To assess the impact of age on STAT screening performance.
Main Methods:
- Seventy-one children (12-23 months) with a family history of ASD or referred for ASD concerns underwent the STAT.
- A follow-up diagnostic evaluation was conducted after 24 months.
- Signal detection analysis was used to determine the STAT's sensitivity, specificity, and predictive values.
Main Results:
- A cut score of 2.75 yielded high sensitivity (0.95) and negative predictive value (0.97).
- Specificity was 0.73, and positive predictive value was 0.56.
- Screening accuracy improved when the STAT was administered to children aged 14 months and older, with fewer false positives in this subgroup.
Conclusions:
- The STAT demonstrates promising screening capabilities for toddlers under 24 months, particularly for identifying children likely not to have ASD.
- The tool's performance is age-dependent, suggesting caution with very young infants (12-13 months).
- Further research is warranted to refine the STAT's use in early toddler screening for autism spectrum disorder.
Abstract:
The study examined the properties of the Screening Tool for Autism in Two-Year-Olds (STAT) for children under 24 months. The STAT provides a standard context for observing social-communicative behavior in play, imitation, and communication. Seventy-one children received the STAT between 12 and 23 months of age and a follow-up diagnostic evaluation after 24 months. All had an older sibling with an autism spectrum diagnosis (n=59) or had been referred for evaluation for concerns about autism (n=12). Signal detection analysis resulted in a cut score of 2.75 for this sample, which yielded a sensitivity of 0.95, specificity of 0.73, positive predictive value of 0.56, and negative predictive value of 0.97. False positives were highest for the 12- to 13-month-old age group; STAT screening properties were improved when the sample was limited to children 14 months and older. Implications for using the STAT with children under 24 months are discussed.
