Identifying Children with Autism Spectrum Disorder at 18 Months in a General Population Sample
Open accessAbstract
Background: Previous research on clinical and high‐risk samples suggests that signs of autism spectrum disorder ( ASD ) can be detected between 1 and 2 years of age. We investigated signs of ASD at 18 months in a population‐based sample and the association with later ASD diagnosis. Methods: The study sample includes 52 026 children born 2003 through 2008 and is a subset of children that participated in the N orwegian Mother and Child Cohort ( MoBa ), a population‐based longitudinal study, and the Autism Birth Cohort ( ABC ), a sub‐study on ASD . Parents completed all 23 items from the Modified Checklist for Autism in Toddlers ( M‐CHAT ) at 18 months. Results: The M‐CHAT 6‐critical‐item criterion and the 23‐item criterion had a specificity of 97.9% and 92.7% and a sensitivity of 20.8% and 34.1%, respectively. In the 173 children diagnosed with ASD to date, 60 children (34.7%) scored above the cut‐off on either of the screening criteria. The items with the highest likelihood ratios were ‘interest in other children’, ‘show objects to others’ and ‘response to name’. Conclusion: Even though one‐third of the children who later received an ASD diagnosis were identified through M‐CHAT items, the majority scored below cut‐off on the screening criteria at 18 months. The results imply that it might not be possible to detect all children with ASD at this age.
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Screening often identifies children with broader developmental difficulties as well as those with ASD.
“Screening also often identifies children with broader developmental difficulties as well as those with ASD 149”
From Autism spectrum disorder (2020) · cites this paper as [149]
These principles also apply in low-income and middle-income countries in which testing for ASD and other neurodevelopmental disabilities has only just begun to be developed.
“These principles also apply in low-income and middle-income countries in which testing for ASD and other neurodevelopmental disabilities has only just begun to be developed 149”
From Autism spectrum disorder (2020) · cites this paper as [149]
The Strengths and Limitations section discusses screening in Norway and says the authors could not assess the impact of social and cultural factors on their results (page unavailable). Our copy does not address whether the study’s principles apply in low- or middle-income countries or whether testing for ASD and other neurodevelopmental disabilities is only beginning there; searches for those settings and cross-country applicability found no supporting passage. (LLM, conf=0.75)
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Cites
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · see citing works
Self-citationLord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005592401947 · Cited by 7,520 · see citing works
Self-citationBaird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., & Charman, T. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69041-7 · Cited by 2,104 · see citing works
Identification and Evaluation of Children With Autism Spectrum Disorders
Johnson, C. P., Myers, S. M., & and the Council on Children With Disabilities (2007) · Pediatrics · doi:10.1542/peds.2007-2361 · Cited by 2,011 · see citing works
Behavioral manifestations of autism in the first year of life
Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2004.05.001 · Cited by 1,602 · see citing works
Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1010738829569 · Cited by 1,563 · see citing works
Early recognition of children with autism: a study of first birthday home videotapes
Osterling, J., & Dawson, G. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172225 · Cited by 1,290 · see citing works
Baranek, G. T. (1999) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1023080005650 · Cited by 1,027 · see citing works
Cohort profile: The Norwegian Mother and Child Cohort Study (MoBa)
Magnus, P. M., Irgens, L. M., Haug, K., Nystad, W., Skjærven, R., & Stoltenberg, C. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl170 · Cited by 1,027 · see citing works
Self-citationA Prospective Study of the Emergence of Early Behavioral Signs of Autism
Ozonoff, S., Iosif, A.-M., Baguio, F., Cook, I. C., Hill, M. M., Hutman, T., Rogers, S. J., Rozga, A., Sangha, S., Sigman, M., et al. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2009.11.009 · Cited by 1,011 · see citing works
Autism From 2 to 9 Years of Age
Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.6.694 · Cited by 973 · see citing works
Self-citationA Screening Instrument for Autism at 18 Months of Age: A 6-Year Follow-up Study
BAIRD, G., CHARMAN, T., BARON-COHEN, S., COX, A., SWETTENHAM, J., WHEELWRIGHT, S., & DREW, A. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200006000-00007 · Cited by 804 · see citing works
Race differences in the age at diagnosis among medicaid-eligible children with autism
MANDELL, D. S., LISTERUD, J., LEVY, S. E., & PINTO-MARTIN, J. A. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200212000-00016 · Cited by 684 · see citing works
Schottenfeld, D. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf028 · Cited by 627 · see citing works
Parental recognition of developmental abnormalities in autism
GIACOMO, A. D., & Fombonne, E. J. (1998) · European Child & Adolescent Psychiatry · doi:10.1007/s007870050058 · Cited by 596 · see citing works
Mack, A. H. (2011) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/j.ypsy.2010.11.009 · Cited by 500 · see citing works
A prospective case series of high-risk infants who developed autism
Bryson, S. E., Zwaigenbaum, L., Brian, J., Roberts, W., Szatmari, P., Rombough, V., & McDermott, C. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0328-2 · Cited by 455 · see citing works
A Prospective Study of the Emergence of Early Behavioral Signs of Autism
Ozonoff, S. J., Iosif, A., Baguio, F., et al. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-201003000-00009 · Cited by 406 · see citing works
Kleinman, J. M., Robins, D. L., Ventola, P. E., Pandey, J., Boorstein, H., Esser, E. L., Wilson, L. B., ROSENTHAL, M. A., Sutera, S., Verbalis, A. D., et al. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-007-0450-9 · Cited by 395 · see citing works
Autism spectrum disorder in the second year: stability and change in syndrome expression
Chawarska, K., Klin, A., Paul, R., & Volkmar, F. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01685.x · Cited by 384 · see citing works
Age of diagnosis for autism: individual and community factors across 10 birth cohorts
Fountain, C., King, M. D., & Bearman, P. S. (2011) · Journal of Epidemiology and Community Health · doi:10.1136/jech.2009.104588 · Cited by 359 · see citing works
Large-Scale Use of the Modified Checklist for Autism in Low-Risk Toddlers
Chlebowski, C., Robins, D. L., Barton, M. L., & Fein, D. (2013) · Pediatrics · doi:10.1542/peds.2012-1525 · Cited by 258 · see citing works
Autism Spectrum Disorder, ADHD, Epilepsy, and Cerebral Palsy in Norwegian Children
Surén, P., Bakken, I. J., Aase, H., Chin, R., Gunnes, N., Lie, K. K., Magnus, P., Reichborn-Kjennerud, T., Schjølberg, S., Øyen, A.-S., et al. (2012) · Pediatrics · doi:10.1542/peds.2011-3217 · Cited by 248 · see citing works
Self-citationWerner, E., Dawson, G., MUNSON, J. A., & Osterling, J. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-005-3301-6 · Cited by 241 · see citing works
Early Autism Detection: Are We Ready for Routine Screening?
Al-Qabandi, M., Gorter, J. W., & Rosenbaum, P. (2011) · PEDIATRICS · doi:10.1542/peds.2010-1881 · Cited by 228 · see citing works
Guidelines for safe work practices in human and animal medical diagnostic laboratories
Miller, M. J., Astles, R., Baszler, T. V., Chapin, K. C., Carey, R. A., Garcia, L. S., Gray, L. D., Larone, D. H., Pentella, M., Pollock, A., et al. (2012) · Cited by 209 · see citing works
Bolton, P. F., Golding, J., Emond, A., & Steer, C. D. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.12.009 · Cited by 193 · see citing works
Snow, A. V., & Lecavalier, L. (2008) · Autism · doi:10.1177/1362361308097116 · Cited by 182 · see citing works
Pandey, J., Verbalis, A. D., Robins, D. L., Boorstein, H., Klin, A., Babitz, T., Chawarska, K., Volkmar, F. R., Green, J., Barton, M. L., et al. (2008) · Autism · doi:10.1177/1362361308094503 · Cited by 163 · see citing works
Ventola, P. E., Kleinman, J. M., Pandey, J., Wilson, L. B., Esser, E. L., Boorstein, H., Dumont-Mathieu, T. M., Marshia, G., Barton, M. L., Hodgson, S., et al. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0177-z · Cited by 150 · see citing works
Differences in Autism Symptoms Between Minority and Non-Minority Toddlers
Tek, S., & Landa, R. J. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1445-8 · Cited by 143 · see citing works
Eaves, L. C., Wingert, H., & Ho, H. H. (2006) · Autism · doi:10.1177/1362361306063288 · Cited by 141 · see citing works
Modified Checklist for Autism in Toddlers: Cross-Cultural Adaptation and Validation in Spain
Canal‐Bedia, R., Primo, P. G., Cilleros, M. V. M., Borbujo, J. S., Fernández, Z. G., Herráez-García, L., Herráez-García, M. D. M., Boada-Muñoz, L., Fuentes-Biggi, J., & de la Paz, M. P. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-1163-z · Cited by 125 · see citing works
Keyes, K. M., Susser, E., Cheslack-Postava, K., Fountain, C., Liu, K., & Bearman, P. S. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dyr193 · Cited by 122 · see citing works
Self-citationThe Autism Birth Cohort: a paradigm for gene–environment–timing research
Stoltenberg, C., Schjølberg, S., Bresnahan, M., Hornig, M., Hirtz, D., Dahl, C., Lie, K. K., Reichborn-Kjennerud, T., Schreuder, P., Alsaker, E., et al. (2010) · Molecular Psychiatry · doi:10.1038/mp.2009.143 · Cited by 119 · see citing works
Self-citationBaghdadli, A., Picot, M., Pascal, C., Pry, R., & Aussilloux, C. (2003) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-003-0314-6 · Cited by 112 · see citing works
Stone, W. L. (1994) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1994.02170020060010 · Cited by 111 · see citing works
Urbanicity and Autism Spectrum Disorders
Lauritsen, M. B., Astrup, A., Pedersen, C. B., Obel, C., Schendel, D., Schieve, L. A., Yeargin‐Allsopp, M., & Parner, E. T. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1875-y · Cited by 100 · see citing works
A new screening programme for autism in a general population of Swedish toddlers
Nygren, G., Sandberg, E., Gillstedt, F., Ekeroth, G., Arvidsson, T., & Gillberg, C. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.02.018 · Cited by 98 · see citing works
Kamio, Y., Inada, N., Koyama, T., Inokuchi, E., Tsuchiya, K., & Kuroda, M. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1864-1 · Cited by 75 · see citing works
Screening for autism spectrum disorders
Williams, J. G., & Brayne, C. (2006) · Autism · doi:10.1177/1362361306057876 · Cited by 52 · see citing works
Yama, B. A., Freeman, T., Graves, E., Yuan, S., & Campbell, M. K. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1211-3 · Cited by 48 · see citing works
Daniels, A. M., & Mandell, D. S. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1831-x · Cited by 41 · see citing works
Rothman, K. J., Huybrechts, K. F., & Murray, E. J. (2024) · doi:10.1093/oso/9780197751541.001.0001 · Cited by 12 · see citing works
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Lord, C., Brugha, T. S., Charman, T., Cusack, J., Dumas, G., Frazier, T., Jones, E. J. H., Jones, R. M., Pickles, A., State, M. W., et al. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0138-4 · Cited by 1,859 · see citing works
Self-citationAccuracy of autism screening in a large pediatric network
Guthrie, W., Wallis, K., Bennett, A., Brooks, E., Dudley, J., Gerdes, M., Pandey, J., Levy, S. E., Schultz, R. T., & Miller, J. S. (2019) · Pediatrics · doi:10.1542/peds.2018-3963 · Cited by 252 · see citing works
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Carbone, P. S., Campbell, K., Wilkes, J., Stoddard, G. J., Huynh, K., Young, P. C., & Gabrielsen, T. P. (2020) · Pediatrics · doi:10.1542/peds.2019-2314 · Cited by 144 · see citing works
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Juárez, A. P., Weitlauf, A. S., Nicholson, A., Pasternak, A., Broderick, N., Hine, J., Stainbrook, J. A., & Warren, Z. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3524-y · Cited by 116 · see citing works
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Kim, S. H., Joseph, R. M., Frazier, J. A., O'Shea, T. M., Chawarska, K., Allred, E. N., Leviton, A., & Kuban, K. K. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.07.052 · Cited by 74 · see citing works
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Sánchez-García, A. B., Galindo-Villardón, P., Nieto-Librero, A. B., Martín-Rodero, H., & Robins, D. L. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-03865-2 · Cited by 66 · see citing works
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Øien, R. A., Schjølberg, S., Volkmar, F. R., Shic, F., Cicchetti, D. V., Nordahl-Hansen, A., Stenberg, N., Hornig, M., Havdahl, A., Øyen, A.-S., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-3596 · Cited by 69 · see citing works
Self-citation
- Authors
- Stenberg, N., Bresnahan, M., Gunnes, N., Hirtz, D., Hornig, M., Lie, K. K., Lipkin, W. I., Lord, C., Magnus, P., Reichborn‐Kjennerud, T., Schjølberg, S., Surén, P., Susser, E., Svendsen, B. K., von Tetzchner, S., Øyen, A., & Stoltenberg, C.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Columbia University (US)
- National Institutes of Health (US)
- NewYork–Presbyterian Hospital (US)
- New York State Psychiatric Institute (US)
- Lovisenberg Diakonale Sykehus (NO)
- Institute of Psychology University of Oslo Oslo Norway
- Corresponding author
- Stenberg, Nina
- ORCID
- Venue
- Paediatric and Perinatal Epidemiology
- Publisher
- Wiley
- Published
- 2014-02-18
- Volume
- 28
- Issue
- 3
- Pages
- 255-262
- ISSN
- 0269-5022 (ISSN-L)
- 1365-3016
- PMC
- PMC3976700
- OpenAlex
- W1540039746
- Cited by
- 130
- References
- 46
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 5 · 2023: 8 · 2022: 22 · 2021: 21 · 2020: 9 · 2019: 15 · 2018: 13 · 2017: 11 · 2016: 11 · 2015: 4 · 2014: 5
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Paediatric and Perinatal Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (NS47537)
- The Research Council of Norway (196452)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- autism spectrum disorder, early detection, toddlers, autism screening, M-CHAT, sensitivity and specificity, likelihood ratios, parent report
- MeSH terms
- Adult, Attention, Child Development Disorders, Pervasive, Educational Status, Female, Humans, Infant, Longitudinal Studies, Male, Mass Screening, Maternal Age, Norway, Parents, Play and Playthings, Surveys and Questionnaires, Sensitivity and Specificity, Social Behavior, Checklist
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