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[Clinical application of M-CHAT and CHAT-23 for autism screening]
Shuang Ren1, Hong-Wei Ma, Man Hu
1Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Insights
The Checklist for Autism in Toddlers-23 (CHAT-23) demonstrates superior clinical applicability for early autism screening in toddlers compared to the Modified Checklist for Autism in Toddlers (M-CHAT). CHAT-23 offers higher specificity and practical advantages for effective autism diagnosis.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Clinical Diagnostics
Background:
- Early identification of autism spectrum disorder (ASD) is crucial for timely intervention.
- Screening tools like the Modified Checklist for Autism in Toddlers (M-CHAT) and Checklist for Autism in Toddlers-23 (CHAT-23) aid in early detection.
- Understanding the comparative clinical utility of these tools is essential for optimizing diagnostic pathways.
Purpose of the Study:
- To compare the clinical applicability of M-CHAT and CHAT-23 in toddlers.
- To analyze the early clinical manifestations of autism in children.
- To provide evidence for selecting the most effective screening tool for autism in young children.
Main Methods:
- A comparative analysis was conducted on 350 children aged 18-36 months.
- Two groups were formed: 68 confirmed autism cases and 278 controls.
- The positive rates for each checklist item were compared, and the efficacy of assessment criteria was evaluated.
Main Results:
- Significant differences in positive item rates were observed between autism and control groups for most items (P<0.05).
- M-CHAT achieved 0% missed diagnosis with a threshold of 3 positive items.
- CHAT-23 achieved 1.77% misdiagnosis with a threshold of 6 positive items, showing higher specificity than M-CHAT (P<0.05).
Conclusions:
- CHAT-23 is more suitable for clinical autism screening than M-CHAT due to its higher specificity.
- CHAT-23 offers advantages including low cost, ease of completion, high efficiency, and straightforward result interpretation.
- The findings support CHAT-23 as a preferred tool for early autism detection in toddlers.
Objective:
To analyze and compare Modified Checklist for Autism in Toddlers (M-CHAT) and Checklist for Autism in Toddlers-23 (CHAT-23) in terms of clinical applicability, and to provide a basis for the understanding of early specific clinical manifestations of children with autism.
Methods:
A total of 350 children aged 18-36 months who visited the Department of Developmental Pediatrics of Shengjing Hospital of China Medical University were enrolled as subjects. Of the 350 children, 284 who had not been previously diagnosed with autism were screened according to the two checklists. Sixty-eight confirmed cases of autism (including two of the 284 screening subjects diagnosed with autism) were assigned to the autism group, and 278 of the 284 screening subjects (except six children diagnosed with autism, mental retardation or cerebral palsy) were assigned to the control group. The two groups were compared with respect to the positive rate for each item in the checklists. The efficacy of the M-CHAT and CHAT-23 assessment criteria was evaluated by comparative analysis.
Results:
The autism group showed the highest positive rate for Item 9. There were significant differences between the two groups in terms of the positive rates for all items except Item 16 (P<0.05). When the assessment criterion was that autism was confirmed if there were positive results for at least 3 of a total of 23 items, M-CHAT showed the lowest rate of missed diagnosis (0%); when the assessment criterion was that autism was confirmed if there were positive results for at least 6 of a total of 23 items, CHAT-23 showed the lowest rate of misdiagnosis (1.77%). The specificity of M-CHAT is lower than that of CHAT-23 (P<0.05). There was no significant difference in sensitivity between the two checklists (P>0.05).
Conclusions:
CHAT-23 is more suitable than M-CHAT for clinical autism screening due to higher specificity, as well as having the advantages of low cost, easy completion,high efficiency and easy result judgment.
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