The Modified Checklist for Autism in Toddlers: A Follow-up Study Investigating the Early Detection of Autism Spectrum Disorders

J Autism Dev Disord (2008) 38:827839 DOI 10.1007/s10803-007-0450-9

ORIGINAL PAPER

The Modied Checklist for Autism in Toddlers: A Follow-up Study Investigating the Early Detection of Autism Spectrum Disorders

Jamie M. Kleinman Diana L. Robins Pamela E. Ventola Juhi Pandey Hilary C. Boorstein Emma L. Esser Leandra B. Wilson Michael A. Rosenthal Saasha Sutera Alyssa D. Verbalis Marianne Barton Sarah Hodgson James Green Thyde Dumont-Mathieu Fred Volkmar Katarzyna Chawarska Ami Klin Deborah Fein

Published online: 20 September 2007 Springer Science+Business Media, LLC 2007

Abstract Autism spectrum disorders (ASD) often go undetected in toddlers. The Modied Checklist for Autism in Toddlers (M-CHAT) was used to screen 3,793 children aged 1630 months from low- and high-risk sources; screen positive cases were diagnostically evaluated. Re-screening was performed on 1,416 children aged 42 54 months. Time1 Positive Predictive Value (PPV) was .36 for the initial screening and .74 for the screening plus follow-up telephone interview; values were similar for Time2 PPV. When separating referral sources, PPV was low for the low-risk sample but acceptable with the follow-up telephone interview. Children with ASD from the low-risk and high-risk samples were highly similar. Results indicate that the M-CHAT continues to be a promising instrument for the early detection of ASD.

Keywords Autism Early identication

Pediatric screening

Introduction

Autism spectrum disorders (ASD) constitute a group of severe disorders of development, disrupting social relationships, communication, play, academic skills, and usually leading to life-long disability. ASD affects up to 60 children in 10,000 (Baird et al. 2000; Bertrand et al. 2001; Chakrabati and Fombonne 2001; Charman 2002; Fombonne 2003; Fombonne et al. 2006) or even more (Baird et al. 2006).

Autism can be difcult to detect in very young children, who are often referred for evaluation later than would be optimal. The average age at which parents rst report concerns is generally reported to be around 1718 months (and most recent data has rst parent concerns at an average of 1415 months, with a signicant number below age 11 months, see Chawarska et al. 2007) but most children are not diagnosed until age 4 or even later, especially urban, low socio-economic status children (see review by Gray et al. 2006). Clear evidence exists, however, that early detection and subsequent early intervention can lead to substantially...