Early detection and treatment have been shown to be effective in reducing disability severity caused by Autistic Spectrum Disorders (ASDs). As Spanish pediatricians have no detection tool, the Modified Checklist for Autism in Toddlers (M-CHAT) was first translated into and culturally adapted to Spanish. Validity and reliability studies were carried out in two different geographical areas of Spain, where M-CHAT was administered to two different samples, namely: 2,480 high- and low-risk children; and 2,055 low-risk children. The results obtained were similar to those yielded by the original M-CHAT studies. Differences were found in positive predictive value, due to the low ASD frequency observed in this study. M-CHAT is still being studied in a large population-based screening program in Spain.
The Modified Checklist for Autism in Toddlers-Revised/Follow-up (M-CHAT-R/F) was developed to reduce the number of cases requiring telephone verification. The aim of this study was to validate a Spanish version of the M-CHAT-R/F in the Spanish public health system. The M-CHAT-R/F was translated, culturally adapted, and then administered to 6,625 children. Of the 39 positive screening cases, 15 children were diagnosed with Autism Spectrum Disorder (ASD) and 24 with non-ASD disorders or delays. The sensitivity was 0.79 and specificity of 0.99. Positive and negative predictive values were 0.39 and 0.99, respectively. These results are similar to the English equivalent, though observed prevalence was lower. This study supports Spanish National Health System policy makers to consider a universal ASD screening program.
This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, danger’, or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior.
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