A Two-Year Follow-up on Risk Status Identified by the Checklist for Autism in Toddlers

Abstract

We examined the characteristics of children at 4 to 5 years of age who were correctly and incorrectly classified as "at risk" for an autism spectrum diagnosis using the Checklist for Autism in Toddlers (CHAT) at age 2 to 3 years. Information is provided on the stability of risk/disorder status over a 2-year period of early development. Participants were 19 children with autism and 11 children with other developmental disabilities who had all been administered the CHAT between 2 and 3 years of age (Time 1) and received diagnostic and developmental re-evaluations between 4 and 6 years of age (Time 2). The risk status of children was discussed based on the original CHAT authors' criteria for risk of autism and the Denver modification for risk. High levels of stability in risk/diagnostic status from Time 1 assessments to Time 2 assessments were noted. Specifically, the original CHAT criteria for medium to high risk of autism applied at Time 1 predicted Time 2 diagnostic classification for 83% of the sample, and the Denver modification of the CHAT risk criteria predicted Time 2 diagnostic classification for 93% of the sample. Implications of the findings are discussed as they relate to early screening and identification of autism spectrum disorders.

Follow up of Children with Autism Spectrum Disorders: Stability and Change in Diagnosis

“…Several studies have demonstrated that pre-school diagnosis of autism made by expert clinicians remain relatively stable 2 to 22 years after initial diagnosis [6][7][8][9][10][11]. Assessing the stability of an initial ASD diagnosis is important for a number of reasons.…”

Stability of Initial Autism Spectrum Disorder Diagnoses in Community Settings

“…Findings from studies conducted in controlled research settings show that the ASDs are fairly stable neuropsychiatric disorders (Cederlund et al 2008;Charman et al 2005;Chawarska et al 2007;Kleinman et al 2008;Lord and Luyster 2006;Moss et al 2008;Scambler et al 2006;Turner et al 2006;Turner and Stone 2007; van Daalen et al 2009) with diagnostic stability (maintaining the same diagnosis within the autism spectrum at times 1 and 2) estimates ranging from 69% to 95% (Charman et al 2005). A recent study, the first on a genetically homogeneous ASD group (fragile X syndrome) found diagnostic stability during a 3-year period to be *60% for AD and 20% for PDD-NOS (Hernandez et al 2009).…”

What’s new in autism?

“…Early psycho-education of the environment and behavioural treatment of specific problems may prevent secondary signs and symptoms and improve adaptive behaviour. While early diagnosis is quite straightforward in severe autism, it has become increasingly clearer that ASD has varying trajectories in early development and that symptoms may overlap with normal developmental variance and with mental retardation [111,135]. To date, there is no diagnostic laboratory test.…”