Can Screening with the Ages and Stages Questionnaire Detect Autism?

Abstract

Objective Parents rely on pediatricians to monitor their child’s development. The American Academy of Pediatrics recommends routine developmental screening with both broadband and autism-specific instruments at specified ages. If broadband screeners can detect autism risk, this might minimize the burden of administering autism-specific screens to all children. The current study examines the ability of the Ages and Stages Questionnaire-Third Edition (ASQ-3) to identify children at risk for autism. We looked at ASQ-3 scores of children who screen positive on the Modified Checklist for Autism in Toddlers-Revised, children who continue to screen positive on the M-CHAT-R follow-up interview, and children diagnosed with ASD. Methods 2848 toddlers, aged 16–30 months, were screened with the ASQ-3 and M-CHAT-R across 20 pediatric sites. Children who screened positive on the M-CHAT-R and its follow-up interview were offered a diagnostic evaluation. Results Using the “monitor and/or fail” cutoff on any domain, the ASQ-3 identified 87% of the children who screened positive on the M-CHAT-R with follow-up and 95% (20/21) of those diagnosed with an ASD. “Monitor and/or Fail” on the Communication domain alone also identified 95% of the diagnosed children. Conclusions Scores below the “monitor” cutoff on the Communication domain of the ASQ-3 can indicate initial concern requiring autism-specific follow-up. If these results are confirmed with a sample large enough to separately examine toddlers of different ages and different cultural backgrounds, it may be feasible to implement a two-stage screening strategy, with autism specific screening reserved for those who are positive on a broad band screen.

Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study

“…13 Although our study could not evaluate autism given the follow-up through 3 years, the ASQ was designed to screen for developmental delays associated with intellectual disabilities or ASD. 36 However, given our relatively smaller sample size in comparison with the study from Denmark (approximately 33 000 exposed), we were unable to rule out weak associations with certainty, although some of the ASQ domains were found to have associations in the 1.20 range for OI/IUI.…”

To Screen or Not to Screen Universally for Autism is not the Question: Why the Task Force Got It Wrong

“…Recent research has also suggested the use of general developmental screening (e.g. PEDS or ASQ) to assess for a range of developmental delays, with the use of an autism specific instrument as a second tier screen for children that fail the initial general development screen may be a useful approach to accurately target autism screening within busy pediatric settings 69, 70 .…”

Accurate Autism Screening at the 18-Month Well-Child Visit Requires Different Strategies than at 24 Months

“…Recently, a widely used general developmental screen, the Ages & Stages Questionnaires- 3rd Ed. (ASQ) (Squires & Bricker, 2009) has been shown to be a possibly clinically valuable pre-screen for ASD with M-CHAT used as the second stage (Hardy, Haisley, Manning & Fein, 2015). …”