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Brief report: can metrics of reporting bias enhance early autism screening measures?
Cora M Taylor1, Alison Vehorn, Hylan Noble
1Vanderbilt Kennedy Center, Treatment and Research in Autism Spectrum Disorders, Vanderbilt University, Nashville, TN, USA, cmtaylor1@geisinger.edu.
Insights
This study introduces new metrics to detect response bias in autism screening. Adjusting for this bias significantly improved accuracy, reducing both false positives and false negatives in early autism risk detection.
Area of Science:
- Developmental Psychology
- Clinical Psychology
- Pediatric Medicine
Background:
- Early detection of autism spectrum disorder (ASD) risk is crucial for timely intervention.
- Current screening tools, like the Modified Checklist for Autism in Toddlers (MCHAT), can be affected by response bias.
- Internal response bias metrics are needed to enhance the accuracy of ASD risk screening.
Purpose of the Study:
- To develop and pilot two internal response bias metrics: over-reporting and under-reporting.
- To evaluate the additive clinical value of these metrics in autism screening practices.
- To improve the accuracy of early autism risk detection in toddlers.
Main Methods:
- Participants included 145 caregivers and children under 36 months presenting with developmental concerns.
- Caregivers completed the MCHAT and a questionnaire with six response bias indicator questions.
- Analysis focused on the impact of removing biased responses on MCHAT accuracy.
Main Results:
- Removal of self-reports indicating potential response bias significantly reduced false positives on the MCHAT.
- The proposed metrics also substantially decreased false negatives within the study sample.
- This demonstrates the clinical utility of internal response bias metrics in refining screening outcomes.
Conclusions:
- Internal response bias metrics show promise for enhancing the accuracy of autism screening.
- Future development of these metrics could address limitations in current screening measures.
- This approach may lead to more reliable early detection of autism spectrum disorder risk.
Abstract:
The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145) participating in first-time diagnostic appointments across our clinical research center due to developmental concerns. Caregivers were asked to complete the Modified Checklist for Autism in Toddlers (MCHAT) as well as a questionnaire embedding six response bias indicator questions. These questions were items that in previous clinical studies had been endorsed by an overwhelming majority of parents within clinically identified populations. Results indicated that removal of self-reports indicative of potential response bias dramatically reduced both false positives and false negatives on the MCHAT within this sample. This suggests that future work developing internal metrics of response bias may be promising in addressing limits of current screening measures and practices.
