Can a Broadband Developmental-Behavioral Screening Test Identify Children Likely to Have Autism Spectrum Disorder?

Abstract

Because services for children with autism spectrum disorder (ASD) are scarce, when children fail a broadband screening measure, providers need to carefully discern which children need ASD evaluations and which do not. This research considers how well a broadband screening test sorts those with and without probable ASD. The subjects were 427 children between 18 and 59 months of age with elevated risk scores on broadband screening, ie, Parents' Evaluation of Developmental Status (PEDS), a 10-item measure eliciting parents' concerns. Parents also completed the Modified Checklist of Autism in Toddlers (M-CHAT), an autism specific screen. The results showed that of the 427 children at risk on PEDS, 34% (N = 144) passed the M-CHAT. To determine whether these potential overreferrals could be reduced, parents' concerns on PEDS were used to predict M-CHAT results. Three or more discrete types of concerns, varying by age, characterized children who failed the M-CHAT while fewer than 3 were associated with passing. This reduced overreferrals by 70% while maintaining high levels of sensitivity (81%). Although compliance with the American Academy of Pediatrics recommendations for both broadband and autism-specific screening at 18 and 24 months is still recommended, viewing performance patterns on a broadband screening test can substantially reduce overreferrals to autism specialty services.

Comparison of a broad-based screen versus disorder-specific screen in detecting young children with an autism spectrum disorder

“…18 Another study indicated that use of the PEDS alone (without a subsequent ASD screen) resulted in an over-referral of ASD assessments. 19 …”

Development and Initial Validation of a Parent Report Measure of the Behavioral Development of Infants at Risk for Autism Spectrum Disorders

“…The 10-item Parents' Evaluation of Developmental Status (PEDS: Glascoe 2006) is a brief parent report of concerns of their child's development that can be used to identify at-risk young children (starting at about 18 months). Glascoe et al (2007) found that 34% of 427, 18-59 month children who were considered at-risk for developmental delay based on the PEDS were identified at risk for ASD based on the Modified Checklist for Autism in Toddlers (M-CHAT: Robins, Fein, Barton, & Green, 2001). The authors identified specific patterns of scores that varied given the child's age that reduced over-referrals and maintained acceptable sensitivity.…”

Autism Spectrum Disorders

“…At the completion of the PEDS, immediate feedback is provided based on the concerns reported by the parents. 49 The PEDS is no cost to the parents and is only ten questions in length; however, as a broadband diagnostic instrument, it may not able to discern a specific developmental disorder (e.g., autism) from other developmental, communication and intellectual disabilities. 49 A second parent report that may be used early in the surveillance process is that of the Autism Diagnostic Interview (ADI).…”