Use of the Screening Tool for Autism in Two-Year-Olds (STAT) for children                 under 24 months

Stone, Wendy L.; McMahon, Caitlin; Henderson, Lynnette M.

doi:10.1177/1362361308096403

Cited by 137 publications

(97 citation statements)

References 56 publications

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“…Although standardized parent report screening tools for autism are available, 3 clinical impression is critical in decision-making, and often overrides information obtained from screening tools. 8 Standardized observational screening measures are promising (ie, Systematic Observation of Red Flags, 9 Screening Tool for Autism in Two-Year Olds 10 ), but have not been adopted and may not be practical in primary care.…”

Section: What This Study Addsmentioning

confidence: 99%

Identifying Autism in a Brief Observation

et al. 2015

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BACKGROUND: Pediatricians, neurologists, and geneticists are important sources for autism surveillance, screening, and referrals, but practical time constraints limit the clinical utility of behavioral observations. We analyzed behaviors under favorable conditions (ie, video of autism evaluations reviewed by experts) to determine what is optimally observable within 10-minute samples, asked for referral impressions, and compared these to formal screening and developmental testing results.METHODS: Participants (n = 42, aged 15 to 33 months) were typically developing controls and children who screened positive during universal autism screening within a large community pediatric practice. Diagnostic evaluations were performed after screening to determine group status (autism, language delay, or typical). Licensed psychologists with toddler and autism expertise, unaware of diagnostic status, analyzed two 10-minute video samples of participants' autism evaluations, measuring 5 behaviors: Responding, Initiating, Vocalizing, Play, and Response to Name. Raters were asked for autism referral impressions based solely on individual 10-minute observations. RESULTS: Children who had autism showed more typical behavior (89% of the time) than atypical behavior (11%) overall. Expert raters missed 39% of cases in the autism group as needing autism referrals based on brief but highly focused observations. Significant differences in cognitive and adaptive development existed among groups, with receptive language skills differentiating the 3 groups.CONCLUSIONS: Brief clinical observations may not provide enough information about atypical behaviors to reliably detect autism risk. High prevalence of typical behaviors in brief samples may distort clinical impressions of atypical behaviors. Formal screening tools and general developmental testing provide critical data for accurate referrals. WHAT'S KNOWN ON THIS SUBJECT:Behavioral observations influence a clinician' s decision to diagnose or refer, and may even override formal screening results. In the case of autism spectrum disorder, an expected rate of atypical behavior during the span of a medical visit is unknown. WHAT THIS STUDY ADDS:We are the first to quantify the high base rates of typical behavior in young children who have autism and language delay. When observation times are brief, the preponderance of typical behaviors may negatively impact referral decision accuracy.

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Section: What This Study Addsmentioning

confidence: 99%

Identifying Autism in a Brief Observation

et al. 2015

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“…39 Recent data indicate that the STAT may also have utility in younger toddlers aged 14 to 23 months, although additional data are needed for this age group. 40 Although the STAT requires a higher level of expertise to administer than parent questionnaires such as the M-CHAT, a recent study provided evidence of the effectiveness of Web-based training of community services providers of various professional backgrounds; this training could enhance the feasibility of the STAT. 52 …”

Section: Screening Tool For Autism In Two-year-oldsmentioning

confidence: 99%

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

et al. 2015

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This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children aged 18 to 24 months can assist in early detection, consistent with current American Academy of Pediatrics' recommendations. We identify ASD-specific and broadband screening tools that have been ev-aluated in large community samples which show particular promise in terms of accurate classification and clinical utility. We also suggest strategies to help overcome challenges to implementing ASD screening in community practice, as well as priorities for future research. Pediatrics 2015;136:S41-S59

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“…The test lasts approximately 20 minutes to complete. The estimated sensitivity and specificity were 95% and 73%, respectively (Stone et al, 2008). However, increased validity in larger studies and community-based samples are required.…”

Section: Screening Tools For Asdsmentioning

confidence: 91%