In The Politics of Autism, I discuss the evaluation and diagnosis of young children. Screening is an important part of the process.
A new study by UC Davis MIND Institute researchers and others finds that an autism screening tool used widely in the U.S. and around the world is effective but has limitations. The findings highlight the need for providers to use their own judgment and be clear with parents about the limits of the tool, called the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up).
The researchers analyzed more than a dozen studies of the screening tool from around the world, which included tens of thousands of children. Their work was published today in Pediatrics.
The M-CHAT-R/F is a tool commonly used by pediatricians to screen children for autism around the world. It includes a set of questions that providers ask parents or caregivers about their child’s development, and usually takes about five minutes to administer. If the child receives a positive screening result, a provider usually recommends further evaluation.
The team found that the tool commonly flagged children as positive for autistic traits, who, after a full assessment, did not receive an autism diagnosis, though most did have other developmental challenges. In addition, a significant portion of children who were flagged as negative for autistic traits were later diagnosed with autism.
“Although the M-CHAT-R/F has a clear role in autism screening, these results remind clinicians that a positive screen is not equivalent to an autism diagnosis,” said lead author Aishworiya Ramkumar, assistant professor in the Department of Pediatrics at the National University of Singapore. Ramkumar is also a former ITPND (International Training Program in Neurodevelopmental Disabilities) fellow at the MIND Institute.
“When clinicians counsel parents and caregivers after a positive screening they must be clear that the child still needs to have a definitive assessment.”
