Narrative systematic review for autism spectrum disorders screening tools in school settings

Area of Science:

• Child Psychology
• Developmental Pediatrics
• Educational Psychology

Background:

• Early identification of autism spectrum disorder (ASD) is vital for improving children's educational and health trajectories.
• School-based screening offers a practical setting for identifying children who may benefit from early intervention.

Purpose of the Study:

• To systematically review global school-based screening tools for ASD in children aged 4-16.
• To analyze the performance of these tools and explore variations across socio-demographic groups.

Main Methods:

• A narrative systematic review of studies published between 2011 and 2024.
• Searched EMBASE, MEDLINE, PsycINFO, Cochrane, and Scopus databases.
• Included studies on mainstream school settings globally, using various ASD screening tools.

Main Results:

• Fourteen studies identified eight distinct school-based ASD screening tools.
• Prevalence of screen-positive cases ranged from 0.7% to 8.5%.
• Sensitivity (58%-94%) and specificity (61%-100%) varied; no single tool was recommended. No studies assessed tool validity based on ethnicity or socioeconomic status.

Conclusions:

• Global ASD screening tools in schools lack standardization and show significant variation.
• There is a critical need for more research on how ethnicity and socioeconomic status impact screening tool effectiveness.
• Collaboration is essential to develop evidence-based universal screening strategies and validate tools for diverse populations.