A Nine-Item Red Flag Sign Card for Identification of Autism Spectrum Disorder among Toddlers Aged 12 to 18 Months

Area of Science:

• Developmental Pediatrics
• Child Psychology
• Autism Spectrum Disorder Research

Background:

• Limited validated screening tools exist for early autism spectrum disorder (ASD) identification in toddlers.
• Early identification is crucial for timely intervention and improved outcomes in ASD.

Purpose of the Study:

• To develop and validate a new screening measure for early identification of ASD in toddlers.
• To assess the validity and reliability of the developed screening tool.

Main Methods:

• Item generation through literature review and content validity assessment.
• Criterion validity established against DSM-5 criteria using case records of children diagnosed with ASD.
• Item reduction from 18 to 9 items, followed by ROC curve analysis for sensitivity and specificity.

Main Results:

• The new measure, Concern-9, demonstrated a significant Area Under the Curve (AUC) of 0.81 (p < 0.001) in ROC analysis.
• Concern-9 achieved a sensitivity of 93.42% and a specificity of 60% when compared against DSM-5 criteria.
• The screening measure was reduced to 9 items, maintaining its diagnostic accuracy.

Conclusions:

• The validated red flag sign card, Concern-9, is an effective tool for early screening and identification of ASD in children aged 12-18 months.
• This tool addresses the need for accessible and reliable early ASD detection methods.