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Using the M-CHAT-R/F to Identify Developmental Concerns in a High-Risk 18-Month-Old Sibling Sample
Amy S Weitlauf1, Alison C Vehorn, Wendy L Stone
1*Vanderbilt Kennedy Center, Treatment and Research Institute for Autism Spectrum Disorders, Nashville, TN; †Department of Pediatrics, Vanderbilt University, Nashville, TN; ‡Department of Psychology, University of Washington, Seattle, WA; §Department of Pediatrics, University of Connecticut, Storrs, CT; ‖Department of Psychiatry, Vanderbilt University, Nashville, TN.
Insights
The Modified Checklist for Autism in Toddlers-Revised, with Follow-Up Interview (M-CHAT-R/F) can identify developmental concerns in high-risk infant siblings. Failing the M-CHAT-R/F at 18 months indicates a significant likelihood of developmental differences or delays.
Area of Science:
- Developmental Pediatrics
- Autism Spectrum Disorder Research
- Early Childhood Development
Background:
- Infant siblings of children with autism spectrum disorder (ASD) have a high recurrence risk.
- Early identification of ASD markers is crucial in this high-risk population.
- The M-CHAT-R/F is validated for low-risk children but its utility in high-risk infants is less studied.
Purpose of the Study:
- To evaluate the effectiveness of the M-CHAT-R/F in identifying developmental concerns in high-risk infant siblings.
- To assess the M-CHAT-R/F's performance in a very young, high-risk population.
Main Methods:
- Screened 74 infant siblings using the M-CHAT-R/F at 18 months of age.
- Assessed diagnostic outcomes between 18 and 43 months.
- Included as part of a larger population-based study.
Main Results:
- The M-CHAT-R/F demonstrated the highest positive predictive value for identifying any developmental concern, including ASD and language delay.
- 33% of siblings who underwent follow-up evaluations received ASD diagnoses.
- An additional 22% of siblings exhibited other developmental concerns.
Conclusions:
- Failing the M-CHAT-R/F at 18 months is a significant predictor of future developmental differences or delays.
- Close developmental monitoring is essential for high-risk infant siblings.
- The M-CHAT-R/F is a valuable tool for early screening in this population.
Objective:
Given the high autism spectrum disorder (ASD) recurrence risk in younger siblings, it is important to identify early ASD markers within this high-risk population. Although there is increasing evidence that the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up Interview can identify many low-risk children during the second year of life, there has yet to be a study of how the M-CHAT-R/F functions in a high-risk sibling population at very young ages.
Methods:
As part of a larger population-based study, the authors screened 74 infant siblings with the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up Interview at 18 months and assessed diagnoses between the ages of 18 and 43 months.
Results:
The M-CHAT-R/F had the highest positive predictive value for identifying children at risk of any developmental concern (i.e., ASD, language delay). Overall, 33% of siblings who presented for follow-up evaluations received ASD diagnoses with an additional 22% showing other developmental concerns.
Conclusion:
Failing the M-CHAT-R/F at 18 months of age raises significant concern that a child will show some degree of developmental difference or delay over time. These findings highlight the need for close developmental monitoring of this high-risk sample.
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