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Screening for autism in older and younger toddlers with the Modified Checklist for Autism in Toddlers

University of Connecticut, Connecticut, USA, juhi_pandey{at}hotmail.com

Alyssa Verbalis

University of Connecticut, Connecticut, USA

Diana L. Robins

Georgia State University, Georgia, USA

Hilary Boorstein

University of Connecticut, Connecticut, USA

Ami Klin

Yale Child Study Center Yale University School of Medicine, Connecticut, USA

Tammy Babitz

Yale Child Study Center,Yale University School of Medicine, Connecticut, USA

Katarzyna Chawarska

Yale Child Study Center,Yale University School of Medicine, Connecticut, USA

Fred Volkmar

Yale Child Study Center,Yale University School of Medicine, Connecticut, USA

James Green

University of Connecticut, Connecticut, USA

Marianne Barton

University of Connecticut, Connecticut, USA

Deborah Fein

University of Connecticut, Connecticut, USA

The Modified Checklist for Autism in Toddlers (M—CHAT) was used to screen younger (16—23 months) versus older (24—30 months) high- and low-risk toddlers. Refusal rates for follow-up interview showed no group differences, but parents of younger/low-risk children were more likely to refuse evaluation than parents of high-risk children. PPP for an ASD diagnosis was: younger/high-risk 0.79, older/high-risk 0.74, younger/low-risk 0.28, and older/low-risk 0.61, with PPP differing by age within the low-risk group. Most of the children in all groups, however, were diagnosed with a developmental disorder. Symptom severity generally did not differ among groups. Cognitive and adaptive measures showed minimal group differences. Therefore, older and younger toddlers had similar symptomatology and developmental delays; PPP for ASD is better at 24 than 18 months for low-risk children; however, these children are still highly likely to show a developmental disorder. Clinical decision making should balance early identification against the lower specificity of M—CHAT screening for the younger/low-risk group.

Key Words: autism spectrum disorders • early detection • early identification • pediatric screening

Autism, Vol. 12, No. 5, 513-535 (2008)
DOI: 10.1177/1362361308094503


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