Developmental characteristics and accuracy of autism screening among two-year-old toddlers in the ECHO program.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
15 Apr 2024
15 Apr 2024
Historique:
received:
27
09
2023
accepted:
18
03
2024
revised:
18
03
2024
medline:
16
4
2024
pubmed:
16
4
2024
entrez:
15
4
2024
Statut:
aheadofprint
Résumé
The Modified Checklist for Autism in Toddlers (M-CHAT) is a common pediatric screening tool with mixed accuracy findings. Prior evidence supports M-CHAT screening for developmental concerns, especially in toddlers born preterm. This study examined M-CHAT accuracy in a large, nationwide sample. 3393 participants from the Environmental influences on Child Health Outcomes (ECHO) program were included. Harmonized M-CHAT (M-CHAT-H) results were compared with parent-reported autism diagnosis and autism-related characteristics to assess accuracy for term and preterm children, together and separately. Generalized estimating equations, clustering for ECHO cohort and controlling for demographic covariates, were used to examine associations between developmental and behavioral characteristics with M-CHAT-H accuracy. Sensitivity of the M-CHAT-H ranged from 36 to 60%; specificity ranged from 88 to 99%. Positive M-CHAT-H was associated with more developmental delays and behavior problems. Children with severe motor delays and more autism-related problems were more likely to have a false-negative M-CHAT-H. Children with fewer behavior problems and fewer autism-related concerns were more likely to have a false-positive screen. The M-CHAT-H accurately detects children at low risk for autism and children at increased risk with moderate accuracy. These findings support use of the M-CHAT-H in assessing autism risk and developmental and behavioral concerns in children. Previous literature regarding accuracy of the Modified Checklist for Autism in Toddlers (M-CHAT) is mixed but this study provides evidence that the M-CHAT performs well in detecting children at low risk for autism and consistently detects children with developmental delays and behavioral problems. The M-CHAT moderately detects children at increased risk for autism and remains a useful screening tool. This study examines M-CHAT accuracy in a large-scale, nationwide sample, examining associations between screening accuracy and developmental outcomes. These findings impact pediatric screening for autism, supporting continued use of the M-CHAT while further elucidating the factors associated with inaccurate screens.
Sections du résumé
BACKGROUND
BACKGROUND
The Modified Checklist for Autism in Toddlers (M-CHAT) is a common pediatric screening tool with mixed accuracy findings. Prior evidence supports M-CHAT screening for developmental concerns, especially in toddlers born preterm. This study examined M-CHAT accuracy in a large, nationwide sample.
METHODS
METHODS
3393 participants from the Environmental influences on Child Health Outcomes (ECHO) program were included. Harmonized M-CHAT (M-CHAT-H) results were compared with parent-reported autism diagnosis and autism-related characteristics to assess accuracy for term and preterm children, together and separately. Generalized estimating equations, clustering for ECHO cohort and controlling for demographic covariates, were used to examine associations between developmental and behavioral characteristics with M-CHAT-H accuracy.
RESULTS
RESULTS
Sensitivity of the M-CHAT-H ranged from 36 to 60%; specificity ranged from 88 to 99%. Positive M-CHAT-H was associated with more developmental delays and behavior problems. Children with severe motor delays and more autism-related problems were more likely to have a false-negative M-CHAT-H. Children with fewer behavior problems and fewer autism-related concerns were more likely to have a false-positive screen.
CONCLUSION
CONCLUSIONS
The M-CHAT-H accurately detects children at low risk for autism and children at increased risk with moderate accuracy. These findings support use of the M-CHAT-H in assessing autism risk and developmental and behavioral concerns in children.
IMPACT
CONCLUSIONS
Previous literature regarding accuracy of the Modified Checklist for Autism in Toddlers (M-CHAT) is mixed but this study provides evidence that the M-CHAT performs well in detecting children at low risk for autism and consistently detects children with developmental delays and behavioral problems. The M-CHAT moderately detects children at increased risk for autism and remains a useful screening tool. This study examines M-CHAT accuracy in a large-scale, nationwide sample, examining associations between screening accuracy and developmental outcomes. These findings impact pediatric screening for autism, supporting continued use of the M-CHAT while further elucidating the factors associated with inaccurate screens.
Identifiants
pubmed: 38622260
doi: 10.1038/s41390-024-03193-5
pii: 10.1038/s41390-024-03193-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
P B Smith
(PB)
L K Newby
(LK)
L P Jacobson
(LP)
D J Catellier
(DJ)
R Gershon
(R)
D Cella
(D)
A N Alshawabkeh
(AN)
J Cordero
(J)
J Meeker
(J)
J Aschner
(J)
S L Teitelbaum
(SL)
A Stroustrup
(A)
S Merhar
(S)
A Lampland
(A)
A Reynolds
(A)
M Hudak
(M)
G Pryhuber
(G)
P Moore
(P)
L Washburn
(L)
D Koinis Mitchell
(D)
S Deoni
(S)
A L Dunlop
(AL)
C Karr
(C)
F Tylavsky
(F)
A Mason
(A)
Q Zhao
(Q)
S Sathyanarayana
(S)
N Bush
(N)
K Z LeWinn
(KZ)
B Lester
(B)
B Carter
(B)
S Pastyrnak
(S)
C Neal
(C)
R K Miller
(RK)
H Simhan
(H)
C Buss
(C)
P Wadhwa
(P)
K Huff
(K)
R Vaidya
(R)
R Obeid
(R)
C Rollins
(C)
K Bear
(K)
M Lenski
(M)
R Singh
(R)
M Msall
(M)
J Frazier
(J)
S Gogcu
(S)
A Montgomery
(A)
K Kuban
(K)
L Douglass
(L)
H Jara
(H)
J Herbstman
(J)
J Stanford
(J)
C Porucznik
(C)
A Giardino
(A)
Informations de copyright
© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
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