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

Abstract

The goals of our study were to (a) compare agreement between autism spectrum disorder diagnosis and outcome of the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status in a sample of toddlers and (b) examine specific concerns noted for toddlers who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were later diagnosed with autism spectrum disorder. Participants were administered the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status during well-child visits. Families were invited for a clinical evaluation if autism spectrum disorder symptoms were noted on the Modified Checklist for Autism in Toddlers and Modified Checklist for Autism in Toddlers Follow-Up Interview or if autism spectrum disorder concerns were noted by the pediatrician. Fifty-two children completed the Modified Checklist for Autism in Toddlers, Parents Evaluation of Developmental Status, and a clinical evaluation, and 30 of these children were diagnosed with an autism spectrum disorder. Modified Checklist for Autism in Toddlers results showed higher agreement with autism spectrum disorder diagnosis than any individual Parents Evaluation of Developmental Status screen result, although the latter detected many children with other developmental concerns. Children who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were diagnosed with autism spectrum disorder had concerns noted in sensory response and proto-declarative pointing that can be considered in the context of screen results. In sum, our findings support universal autism spectrum disorder–specific screening in addition to general developmental screening and offer considerations to encourage early identification of toddlers with autism spectrum disorder.

Moving From Research to Practice in the Primary Care of Children With Autism Spectrum Disorders

“…56 The M-CHAT has been shown to outperform a broadband developmental screening tool (The Parents' Evaluation of Developmental Status [PEDS]) in identifying children with ASD, suggesting that the use of a separate instrument to screen for ASD is justified. 57,58 IMPROVING SURVEILLANCE AND SCREENING While research supports the effectiveness of ASD surveillance and screening in the early identification of children with ASD, primary care pediatricians report a lack of self-efficacy in ASD surveillance and infrequently use ASD screening tools. 3,59 Pediatric residents report that learning more about ASD is important but describe their current level of training as inadequate.…”

Can Screening with the Ages and Stages Questionnaire Detect Autism?

“…However, neither of these studies on the PEDS conducted formal ASD evaluations. A recent study by Wiggins and colleagues (27) compared the agreement of the PEDS and M-CHAT screeners with the results of a comprehensive clinical autism evaluation. While the M-CHAT demonstrated higher agreement with the clinical diagnosis, all children diagnosed with an ASD demonstrated at least one domain of concern on the PEDS, indicating good sensitivity for ASD if a fairly low threshold is used.…”

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

“…Examine how broadband and ASDspecific screening tools can be used 54 reported that the M-CHAT had higher sensitivity for ASD than the high-risk threshold for any area of general concern covered by the PEDS. Although the PEDS detected many children with other developmental concerns, sensitivity for ASD could not be achieved without lowering the screen-positive threshold to a level that would identify a substantial proportion of the general population (25%).…”