Screening for autism spectrum disorders in primary care settings
Open accessAbstract
The need for autism-specific screening during pediatric well-child visits has been established. However, additional support for specific screening instruments is needed. The current study used the Modified Checklist for Autism in Toddlers (M—CHAT) and the M—CHAT Follow-Up Interview to screen 4797 children during toddler checkups. Of the 4797 cases, 466 screened positive on the M—CHAT; of the 362 who completed the follow-up interview, 61 continued to show risk for autism spectrum disorders (ASDs). A total of 41 children have been evaluated; 21 children have been diagnosed with ASD, 17 were classified with non-ASD delays, and three were typically developing. The PPV of M—CHAT plus interview was .57. It is notable that only four of the 21 cases of ASD were flagged by their pediatrician. These findings suggest that the M—CHAT is effective in identifying ASD in primary care settings. Future research will follow this sample longitudinally.
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The M-CHAT has been validated in two large validation studies.
“The M–CHAT has been validated in two large validation studies.”
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Flagged first, then by citations
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“Additionally, early screening strategies are being evaluated to enable detection and referral in the first year of life (Bryson et al. 2008) and before the second birthday (Dietz et al. 2006; Reznick et al. 2007; Robins 2008; Wetherby et al. 2008).”
BackgroundMethodAutism spectrum disorder: advances in diagnosis and evaluation
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“ASD screening tools are designed to elicit parents’ observations regarding early ASD-related behaviors, with evidence of increased sensitivity relative to open-ended questions about parental concerns.(40) Uptake into clinical practice remains modest despite current practice guidelines(38) but could be improved if perc…”
BackgroundCharman, T., & Gotham, K. (2013) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2012.00664.x · Cited by 185 · see citing works
“Robins (2008) found a much lower (0.06) PPV in an unselected sample attending well-child visits, but following the telephone interview the PPV increased to 0.57.”
BackgroundResultInfluentialZwaigenbaum, L., Bryson, S. E., Brian, J., Smith, I. M., Roberts, W., Szatmari, P., Roncadin, C., Garon, N., & Vaillancourt, T. (2016) · Autism Research · doi:10.1002/aur.1585 · Cited by 165 · see citing works
“There is growing evidence that ASD screening leads to earlier detection of ASD compared with general surveillance by community pediatricians [Pandey et al., 2008; Robins, 2008; Robins et al., 2014].”
Stadnick, N. A., Stahmer, A. C., & Brookman-Frazee, L. I. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2376-y · Cited by 156 · see citing works
Screening Young Children for Autism Spectrum Disorders in Primary Practice
Barton, M. L., Dumont-Mathieu, T. M., & FEIN, D. A. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1343-5 · Cited by 151 · see citing works
“…Brayne 2006) have advocated deferring universal screening for ASDs until such comprehensive data can be collected, the consensus appears to be that despite a limited data base regarding the psychometric properties of specific screeners, the value of screening far exceeds the risks (Robins 2008).”
BackgroundInfluentialKhowaja, M., HAZZARD, A. P., & Robins, D. L. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2339-8 · Cited by 137 · see citing works
“The M-CHAT and Follow-Up has a positive predictive value (PPV) for ASD of .54 to .65, and a PPV for all developmental delays that warrant intervention of .90 to .98 (Robins 2008; Kleinman et al. 2008; Chlebowski et al. 2013).”
InfluentialSelf-citationAge of First Words Predicts Cognitive Ability and Adaptive Skills in Children with ASD
Mayo, J., Chlebowski, C., FEIN, D. A., & Eigsti, I. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1558-0 · Cited by 129 · see citing works
“Detailed information about the M-CHAT is available elsewhere (Kleinman et al. 2008; Robins 2008; Robins et al. 2001; Robins and Dumont-Mathieu 2006).”
MethodThe Each Child Study: Systematic Screening for Autism Spectrum Disorders in a Pediatric Setting
Miller, J. S., Gabrielsen, T. P., Villalobos, M., Alleman, R., Wahmhoff, N. K., Carbone, P. S., & Segura, B. (2011) · PEDIATRICS · doi:10.1542/peds.2010-0136 · Cited by 127 · see citing works
Hicks, S. D., Ignacio, C., Gentile, K. L., & Middleton, F. A. (2016) · BMC Pediatrics · doi:10.1186/s12887-016-0586-x · Cited by 128 · see citing works
“Thus, the mean age of diagnosis for children with ASD is 3 years, and approximately half of these are false-positives [3].”
BackgroundEarly detection for autism spectrum disorder in young children
Zwaigenbaum, L., Brian, J. A., & Ip, A. (2019) · Paediatrics & Child Health · doi:10.1093/pch/pxz119 · Cited by 134 · see citing works
“, M-CHAT and the Infant Toddler Checklist [ITC]) detected ASD earlier and more consistently (49,50).”
BackgroundModified 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
“This has also been suggested in other studies ( Robins 2008 ).”
ResultGuy, A., Seaton, S. E., Boyle, E. M., Draper, E. S., Field, D. J., Manktelow, B. N., Marlow, N., Smith, L. K., & Johnson, S. J. (2014) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2014.10.053 · Cited by 99 · see citing works
“17-19 These interviews were shown to reduce the rate of positive screens and substantially improve positive predictive values for ASD.”
InfluentialA 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
Screening for Autism in Iranian Preschoolers: Contrasting M-CHAT and a Scale Developed in Iran
Samadi, S. A., & McConkey, R. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2454-1 · Cited by 94 · see citing works
“However Robins (2008) in a study of unselected toddlers reported a positive predictive value of 6 % but this rose to 57 % after follow-up interviews, In these studies the internal reliability of the M-CHAT was high with a Chronbach’s alpha of 0.85.”
BackgroundInfluentialPierce, K., Courchesne, E., & Bacon, E. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.06.004 · Cited by 91 · see citing works
“For example, in a universal screening study,7 toddlers identified as having ASD in the general population around age 17 months were found to have a mean total score of 16.8 on the Autism Diagnostic Observation Schedule (ADOS), which signifies fairly symptomatic levels of ASD.”
InfluentialPrimary care for children with autism.
Carbone, P. S., Farley, M. A., & Davis, T. (2010) · PubMed · Cited by 88 · see citing works
Veness, C., Prior, M. R., Bavin, E. L., Eadie, P. A., Cini, E., & Reilly, S. (2011) · Autism · doi:10.1177/1362361311399936 · Cited by 86 · see citing works
“A number of studies have focused on screening and follow-up of very young children (Chawarska et al., 2007; Robins, 2008; Wetherby et al., 2008) in whom early signs can be identified.”
BackgroundScreening for Autism in Young Children
Ibañez, L. V., Stone, W. L., & Coonrod, E. E. (2014) · Wiley eBooks · doi:10.1002/9781118911389.hautc24 · Cited by 81 · see citing works
Olliac, B., Crespin, G. C., Laznik, M.-C., Ganouni, O. C. I. E., Sarradet, J.-L., Bauby, C., Dandres, A.-M., Ruiz, E., Bursztejn, C., Xavier, J., et al. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188831 · Cited by 79 · 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
“2001); only a few have been examined in total population studies (Baird et al. 2000; Dietz et al. 2006; Pandey et al. 2008; Robins 2008).”
BackgroundMethodInfluentialPediatric Healthcare Professionals’ Views on Autism Spectrum Disorder Screening at 12–18 Months
Crais, E. R., McComish, C., Humphreys, B. P., Watson, L. R., Baranek, G. T., Reznick, J. S., Christian, R., & Earls, M. F. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2101-2 · Cited by 76 · see citing works
“Further, some PHPs used the MCHAT, but were not aware of the follow-up interview questions, despite strong recommendations that the MCHAT only be used with the follow-up questions to help lower the rate of false positive results (Kleinman et al. 2008; Robins 2008; Wetherby et al. 2008).”
MethodToddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy
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
Self-citationYuen, T., Penner, M., Carter, M. T., Szatmári, P., & Ungar, W. J. (2018) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.13964 · Cited by 69 · see citing works
“This meta-analysis quantitatively summarized the accuracy of the M-CHAT.”
BackgroundMethodInfluentialDevelopmental and Autism Screening Through 2-1-1
Roux, A. M., Herrera, P., Wold, C. M., Dunkle, M. C., Glascoe, F. P., & Shattuck, P. T. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.08.011 · Cited by 68 · see citing works
An Abbreviated Screening Instrument for Autism Spectrum Disorders
Smith, N. J., Sheldrick, R. C., & Perrin, E. C. (2012) · Infant Mental Health Journal · doi:10.1002/imhj.21356 · Cited by 67 · see citing works
“The positive predictive validity has been reported between 0.28 and 0.83 (Pandey et al., 2008; Robins, 2008; Snow & Lecavalier, 2008).”
BackgroundResultInfluentialHoang, V. M., Vui, L. T., Chu, T. T. Q., Le, B. N., Duong, M. D., Thanh, N. M., Pham, V. T., Minas, H., & Ha, B. T. T. (2019) · International Journal of Mental Health Systems · doi:10.1186/s13033-019-0285-8 · Cited by 67 · see citing works
Predictive and Concurrent Validity of Parent Concern About Young Children at Risk for Autism
Hess, C. R., & Landa, R. J. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1282-1 · Cited by 66 · see citing works
“It is also necessary to supplement universal screeners with autism-specific screeners, such as the Modified Checklist for Autism in Toddlers (M-CHAT; Robins et al. 1999) paired with the M-CHAT follow-up questionnaire to reduce false positives (Robins 2008; Kleinman et al. 2008).”
BackgroundCan screening with the ages and stages questionnaire detect autism?
Hardy, S., Haisley, L., Manning, C., & Fein, D. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000201 · Cited by 61 · see citing works
“Communication 5 (23) 15 (71) 20 (95) 1 (4)”
Advances in the early detection of autism
Zwaigenbaum, L. (2010) · Current Opinion in Neurology · doi:10.1097/wco.0b013e3283372430 · Cited by 64 · see citing works
Mozolic‐Staunton, B., Donelly, M., Yoxall, J., & Barbaro, J. (2019) · Research in Autism · doi:10.1016/j.rasd.2019.101496 · Cited by 63 · see citing works
Maskari, T. S. A., Melville, C. A., & Willis, D. S. (2018) · International Journal of Mental Health Systems · doi:10.1186/s13033-018-0200-8 · Cited by 64 · see citing works
Narzisi, A., Calderoni, S., Maestro, S., Calugi, S., Mottes, E., & Muratori, F. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.12.020 · Cited by 63 · see citing works
Windham, G. C., Smith, K. S., Rosen, N. J., Anderson, M., Grether, J. K., Coolman, R. B., & Harris, S. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2032-y · Cited by 62 · see citing works
Marks, K., Glascoe, F. P., & Macias, M. M. (2011) · Clinical Pediatrics · doi:10.1177/0009922811406263 · Cited by 62 · see citing works
“Multiple studies indicate that when the M-CHAT is positive, the FI is needed; without the interview, the M-CHAT identified 6% to 10% of children screened during 18- and 24-month well visit at risk for autism, which would lead to a high overreferral rate for an expensive comprehensive ASD evaluation.(44,47,48) Children…”
BackgroundAutism and Pediatric Practice: Toward a Medical Home
Hyman, S. L., & Johnson, J. K. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1474-3 · Cited by 61 · see citing works
Zwaigenbaum, L., Duku, E., Fombonne, E. J., Szatmári, P., Smith, I. M., Bryson, S. E., Mirenda, P., Vaillancourt, T., Volden, J., Georgiades, S., et al. (2018) · Paediatrics & Child Health · doi:10.1093/pch/pxy076 · Cited by 59 · see citing works
“Given that parent-report questionnaires have been shown to identify ASD earlier (47) and more consistently (49,50) than open-ended inquiry regarding parental concerns, further consideration is needed regarding using such tools; for example, in primary care settings where developmental concerns may come to practitioner…”
BackgroundPrevalence of Autism Spectrum Disorder in Nurseries in Lebanon: A Cross Sectional Study
Chaaya, M., Saab, D., Maalouf, F. T., & Boustany, R. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2590-7 · Cited by 59 · see citing works
“In a more recent study, Robins (2008) reported the positive predictive value to be 0.57 with follow-up interview and 0.058 when the follow-up interview is not conducted.”
BackgroundMethodInfluentialImproving Early Identification and Ongoing Care of Children With Autism Spectrum Disorder
Carbone, P. S., Norlin, C., & Young, P. C. (2016) · PEDIATRICS · doi:10.1542/peds.2015-1850 · Cited by 61 · see citing works
Autism Screening With Online Decision Support by Primary Care Pediatricians Aided by M-CHAT/F
STURNER, R. A., Howard, B. J., Bergmann, P. E., Morrel, T. M., Andon, L., Marks, D., Rao, P. A., & Landa, R. J. (2016) · PEDIATRICS · doi:10.1542/peds.2015-3036 · Cited by 58 · see citing works
Distinct ERP profiles for auditory processing in infants at-risk for autism and language impairment
Riva, V., Cantiani, C., Mornati, G., Gallo, M. N., Villa, L. M., Mani, E., Saviozzi, I., Marino, C., & Molteni, M. (2018) · Scientific Reports · doi:10.1038/s41598-017-19009-y · Cited by 63 · see citing works
Johnson, S. J., Waheed, G., Manktelow, B. N., Field, D. J., Marlow, N., Draper, E. S., & Boyle, E. M. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.10.002 · Cited by 57 · see citing works
Screening Tools for Autism Spectrum Disorder in Primary Care: A Systematic Evidence Review
Levy, S. E., Wolfe, A. E., Coury, D. L., Duby, J. C., Farmer, J. G., Schor, E. L., Cleave, J. M. V., & Warren, Z. E. (2020) · PEDIATRICS · doi:10.1542/peds.2019-1895h · Cited by 56 · see citing works
“In one fair-quality study, ,20% of children screening at risk were flagged by surveillance.(35) An additional fair-quality study in the United States screened toddlers at all scheduled medical appointments (well-child, sick, follow-up, injection visit) over 6 months at a large community-based pediatric practice.”
BackgroundThe Modified Checklist for Autism in Toddlers: Reliability in a Diverse Rural American Sample
Scarpa, A., Reyes, N., Patriquin, M. A., Lorenzi, J., Hassenfeldt, T. A., Desai, V. J., & Kerkering, K. W. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1779-x · Cited by 55 · see citing works
“Many studies of the M-CHAT report percentages for the number of Caucasians, African-Americans, Latinos, and Asians who participate in their projects, but few go on to discuss differences among these groups (e.g., Kleinman et al. 2008; Robins 2008).”
BackgroundResultInfluentialMatson, J. L., Rieske, R. D., & Tureck, K. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.03.006 · Cited by 53 · see citing works
Pham, C., Symeonides, C., O’Hely, M., Sly, P. D., Knibbs, L. D., Thomson, S. M., Vuillermin, P., Saffery, R., Ponsonby, A., & the Barwon Infant Study Investigator Group (2022) · Autism · doi:10.1177/13623613211068223 · Cited by 52 · see citing works
“Early signs of ASD can be observed in the first few years of life (Robins, 2008; Werner et al., 2000), with electroencephalographic abnormalities shown in the first few months after birth (Precenzano et al., 2020), indicating prenatal factors may be important.”
BackgroundGender Differences in Core Symptomatology in Autism Spectrum Disorders across the Lifespan
Taylor, T., & Matson, J. L. (2011) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-011-9235-3 · Cited by 53 · see citing works
“Further research of the psychometric properties of the M-CHAT has been conducted (L. C. Eaves, Wingert, & Ho, 2006; Kleinman, et al., 2008; Kuban, et al., 2009; Pandey, et al., 2008; Robins, 2008; Snow & Lecavalier, 2008).”
MethodThe Clinician's Guide to Autism
Harrington, J. W., & Allen, K. (2014) · Pediatrics in Review · doi:10.1542/pir.35-2-62 · Cited by 58 · see citing works
Baduel, S., Guillon, Q., Afzali, M. H., Foudon, N., Kruck, J., & Rogé, B. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2950-y · Cited by 49 · 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
“Additionally, while the follow-up telephone interview has been applied in many studies (Robins et al. 2001; Kleinman et al. 2008; Pandey et al. 2008; Robins 2008 ) its use is not unanimous (Snow and Lecavalier 2008; Limperopoulos et al. 2008).”
MethodResultInfluentialAutism Spectrum Disorders: Diagnosis and Treatment
Lordan, R., Storni, C., & Benedictis, C. A. D. (2021) · Exon Publications eBooks · doi:10.36255/exonpublications.autismspectrumdisorders.2021.diagnosis · Cited by 45 · see citing works
Screening Children for Autism in an Urban Clinic Using an Electronic M-CHAT
Harrington, J. W., Bai, R., & Perkins, A. M. (2012) · Clinical Pediatrics · doi:10.1177/0009922812463957 · Cited by 45 · see citing works
A systematic review of screening tools in non-young children and adults for autism spectrum disorder
Hirota, T., So, R., Kim, Y. S., LEVENTHAL, B. L., & EPSTEIN, R. A. (2018) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2018.05.017 · Cited by 46 · see citing works
Veness, C., Prior, M. R., Eadie, P. A., Bavin, E. L., & Reilly, S. (2014) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.12614 · Cited by 44 · see citing works
Wiggins, L. D., Piazza, V., & Robins, D. L. (2014) · Autism · doi:10.1177/1362361312466962 · Cited by 42 · see citing works
“The M-CHAT FUI improves the specificity and positive predictive value of the M-CHAT by reducing the false positive rate (Kleinman et al., 2008; Robins, 2008).”
BackgroundSelf-citationEarly Autism Diagnosis in the Primary Care Setting
James, S., & Smith, C. J. (2020) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2020.100827 · Cited by 59 · see citing works
SUNITA, S., & Bilszta, J. L. C. (2012) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2012.02558.x · Cited by 40 · see citing works
Developmental Approaches to Understanding and Treating Autism
Charman, T. (2010) · Folia Phoniatrica et Logopaedica · doi:10.1159/000314032 · Cited by 35 · see citing works
Estimación de la prevalencia de trastorno del Espectro Autista en población urbana chilena
Yáñez, C., Maira, P., Elgueta, C., Brito, M., Crockett, M. A., Troncoso, L., López, C., & Troncoso, M. (2021) · Andes pediatrica · doi:10.32641/andespediatr.v92i4.2503 · Cited by 38 · see citing works
Screening for autism spectrum disorder in very preterm infants during early childhood
Gray, P. H., Edwards, D. M., O'Callaghan, M. J., & GIBBONS, K. S. (2015) · Early Human Development · doi:10.1016/j.earlhumdev.2015.02.007 · Cited by 38 · see citing works
“The infants in the current study were identified at birth while the infants in the studies that have reported higher rates of positive screening were recruited from infants attending doctors' clinics [15,32].”
BackgroundPostpartum depression and child development in first year of life
Morais, M. D. L. S. E., Lucci, T. K., & Otta, E. (2013) · Estudos de Psicologia (Campinas) · doi:10.1590/s0103-166x2013000100002 · Cited by 38 · see citing works
“Robins (2008) highlights its importance as a screening tool for developmental problems, being desirable that it be applied in childcare.”
BackgroundChahin, S. S., Apple, R. W., Kuo, K. H., & Dickson, C. A. (2020) · Translational Pediatrics · doi:10.21037/tp.2019.11.06 · Cited by 38 · see citing works
“The MCHAT-revised followed in 2009 (10).”
Thomas, R. E., Spragins, W., Mazloum, G., Cronkhite, M., & Maru, G. S. (2016) · Child Care Health and Development · doi:10.1111/cch.12333 · Cited by 38 · see citing works
Zaqueu, L. D. C. C., Teixeira, M. C. T. V., Alckmin-Carvalho, F., & Paula, C. S. (2015) · Psicologia Teoria e Pesquisa · doi:10.1590/0102-37722015032243293302 · Cited by 37 · see citing works
Screening for ASD with the Korean CBCL/1½–5
Rescorla, L. A., Kim, Y. A., & Oh, K. J. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2255-y · Cited by 37 · see citing works
Coelho-Medeiros, M. E., Bronstein, J., Aedo, K., Pereira, J. A., Arraño, V., Perez, C. A., Valenzuela, P. M., Moore, R., Garrido, I., & Bedregal, P. (2019) · Revista chilena de pediatría · doi:10.32641/rchped.v90i5.703 · Cited by 37 · see citing works
Engaging Pediatricians in Developmental Screening: The Effectiveness of Academic Detailing
Honigfeld, L., Chandhok, L., & Spiegelman, K. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1344-4 · Cited by 36 · see citing works
“The CHAT and M-CHAT screening tools also have been validated for use in pediatric primary care practices (Robins 2008).”
MethodInstrumentos para Rastreamento de Sinais Precoces do Autismo: Revisão Sistemática
Seize, M. D. M., & Borsa, J. C. (2017) · Psico-USF · doi:10.1590/1413-82712017220114 · Cited by 43 · see citing works
“…de Cronbach = 0,85 Tempo 1: PPV = 0,36 (questionário); PPV = 0,74 (entrevista) Tempo 2: PPV = 0,38 (questionário); PPV = 0,59 (entrevista) Robins (2008) População geral: 18-24 meses (N = 4.797)PPV = 0,57 M-CHAT/R-F Robins et al. (2014) População geral: 18-24 meses (N = 16.071) Precisão:…”
BackgroundInfluentialCharman, T. (2014) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2013.859732 · Cited by 33 · see citing works
“Robins (2008) found a much lower (0.06) PPV in an unselected sample of 4797 children aged 14 – 30 months attending well-child visits, but following the telephone interview the PPV increased to 0.57.”
BackgroundInfluentialMoving From Research to Practice in the Primary Care of Children With Autism Spectrum Disorders
Carbone, P. S. (2013) · Academic Pediatrics · doi:10.1016/j.acap.2013.04.003 · Cited by 33 · see citing works
Bellesheim, K. R., Kizzee, R. L., Curran, A. B., & Sohl, K. (2020) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000796 · Cited by 32 · see citing works
“Survey responses by participating PCPs indicated that common perceived barriers were similar to those described in the literature: lack of sufficient time to administer screenings, lack of self-efficacy in managing children with ASD, and lack of access to ASD specialists.(9,11) Participation in ECHO Autism, including…”
BackgroundMethodAutism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners
STURNER, R. A., Howard, B. J., Bergmann, P. E., Attar, S. M., Stewart, L., Bet, K., Allison, C. L., & Baron‐Cohen, S. (2022) · Molecular Autism · doi:10.1186/s13229-021-00480-4 · Cited by 32 · see citing works
DiGuiseppi, C., Rosenberg, S. A., Tomcho, M. A., Colborn, K., Hightshoe, K., Gutiérrez-Raghunath, S., Cordova, J. M., Dooling-Litfin, J. K., & Rosenberg, C. R. (2021) · Autism · doi:10.1177/1362361320974175 · Cited by 31 · see citing works
“Children are screened at 18- and 24-month well visits using the Modified Checklist for Autism in Toddlers– Revised with Follow-up (M-CHAT-R/F) (Robins, 2008; Robins et al., 2009, 2014), a two-step parent-report screener.”
MethodKoh, H. C., Lim, S. H., Chan, G. F. C., Lin, M. B., Lim, H. H., Choo, S. H. T., & Magiati, I. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1880-1 · Cited by 31 · see citing works
Autism Spectrum Disorder Screening in Primary Care
Gura, G. F., Champagne, M. T., & Blood‐Siegfried, J. (2010) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3182040aea · Cited by 31 · see citing works
Autism and General Developmental Screening Practices Among Primary Care Providers
Mazurek, M. O., Kuhlthau, K., Parker, R. A., Chan, J., & Sohl, K. (2021) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000909 · Cited by 30 · see citing works
Garg, P. (2014) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2014/8243.4527 · Cited by 31 · see citing works
STURNER, R. A., Howard, B. J., Bergmann, P. E., Morrel, T. M., Landa, R. J., Walton, K., & Marks, D. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3231-0 · Cited by 28 · see citing works
“Importantly, our results better represent the true performance of the M-CHAT/F for younger toddlers because, in contrast to these other studies, the M-CHAT/F was completed at nearly the same time as the 18-month check-up rather than via telephone interviews an average of 3 months later when tests for ASD all have high…”
ResultScreening for Autism Spectrum Disorder: Profiles of Children Who Are Missed
Beacham, C., Reid, M., Bradshaw, J. L., Lambha, M., Evans, L. M., Gillespie, S. E., Klaiman, C., & Richardson, S. S. (2018) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000607 · Cited by 29 · see citing works
Kamio, Y., Haraguchi, H., Stickley, A., Ogino, K., Ishitobi, M., & Takahashi, H. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2527-1 · Cited by 27 · see citing works
“…18-month-old children might need more support through a two-step screening process compared to those of low-risk 24-month-old children, while Robins (2008) stated that the use of the followup interview for screen-positive children on the M-CHAT questionnaire should be integrated into the…”
InfluentialAutism Screening: Where Do We Go From Here?
Zwaigenbaum, L., & Maguire, J. L. (2019) · PEDIATRICS · doi:10.1542/peds.2019-0925 · Cited by 26 · see citing works
The marmoset as a model for investigating the neural basis of social cognition in health and disease
Samandra, R., Haque, Z. Z., Rosa, M. G. P., & Mansouri, F. A. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104692 · Cited by 23 · see citing works
Samango‐Sprouse, C. A., Stapleton, E. J., Aliabadi, F., Graw, R., Vickers, R., Haskell, K., Sadeghin, T., Jameson, R., Parmele, C. L., & Gropman, A. L. (2014) · Autism · doi:10.1177/1362361314521329 · Cited by 26 · see citing works
“…in infancy and difficulty identifying reliable biomarkers and known variance in developmental trajectories of infants (Barbaro and Dissanayake, 2010; Kleinman et al., 2008; Luyster et al., 2011; Miller et al., 2011; Robins, 2008; Robins et al., 2001; Rogers, 2009; Wetherby and Prizant, 2002).”
BackgroundMimura, K., Oga, T., Sasaki, T., Nakagaki, K., Sato, C., Sumida, K., Hoshino, K., Saito, K., Miyawaki, I., Suhara, T., et al. (2019) · NeuroImage · doi:10.1016/j.neuroimage.2019.04.006 · Cited by 26 · see citing works
Lee, H. Y., Vigen, C. L. P., Zwaigenbaum, L., Bryson, S. E., Smith, I. M., Brian, J. A., Watson, L. R., Crais, E. R., Turner‐Brown, L., Reznick, J. S., et al. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04208-5 · Cited by 25 · see citing works
“For example, Level 1, low-risk or first-stage screening is typically conducted at the general population level, whereas Level 2 screening involves a subsample of the population that is at risk for the disorder and frequently requires more time or expertise for administration (Robins 2008).”
BackgroundMeasures of Child Development: A review
Bedford, H. E., Walton, S. A., & Ahn, J. J. (2013) · UCL Discovery (University College London) · Cited by 25 · see citing works
Li, C., Zhu, G., Feng, J., Xu, Q., Zhou, Z., Zhou, B., Hu, C., Liu, C., Li, H., Wang, Y., et al. (2018) · Autism Research · doi:10.1002/aur.1984 · Cited by 27 · see citing works
“To address this problem, many countries in North America and Europe carry out early ASD screening among children younger than 3 years [Noland & Gabriels, 2004; Robins, 2008; Chlebowski, Robins, Barton, & Fein, 2013].”
BackgroundPerformance of the Modified Checklist for Autism in Toddlers in Spanish-Speaking Patients
Kimple, K. S., Bartelt, E. A., Wysocki, K. L., & Steiner, M. J. (2014) · Clinical Pediatrics · doi:10.1177/0009922814522346 · Cited by 24 · see citing works
“the standardized follow up interview intended for use in conjunction with the M-CHAT is designed to decrease false positives.(12,17) Initially, revisions to the tool were aimed at decreasing the need for the follow-up questionnaire to facilitate screening in a busy pediatric office.”
MethodFactors influencing autism spectrum disorder screening by community paediatricians
Ip, A., Zwaigenbaum, L., Nicholas, D. B., & Sharon, R. (2015) · Paediatrics & Child Health · doi:10.1093/pch/20.5.e20 · Cited by 21 · see citing works
Beuker, K. T., Schjølberg, S., Lie, K. K., Willemsen‐Swinkels, S. H. N., Rommelse, N. N. J., & Buitelaar, J. K. (2014) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-014-0561-8 · Cited by 20 · see citing works
The modified checklist for autism in Turkish toddlers: A different cultural adaptation sample
Kondolot, M., Özmert, E. N., Öztop, D. B., Mazıcıoğlu, M. M., Gümüş, H., & Elmalı, F. (2015) · Research in Autism · doi:10.1016/j.rasd.2015.10.006 · Cited by 20 · see citing works
Early identification and intervention services for children with autism in Vietnam
Tran, C. V., Weiss, B., Khuc, T. N., Tran, T. T., Nguyen, T. T. N., Hoa, N. T. K., & Dao, T. T. T. (2015) · Health Psychology Report · doi:10.5114/hpr.2015.53125 · Cited by 20 · see citing works
“A number of assessment tools are available for early identification (e.g., the CHAT [Checklist for Autism in Toddlers]; the updated M-CHAT; Robins, Barton, & Green, 2001; Robins & Dumont-Mathieu, 2006; Robins, 2008).”
BackgroundUrban and Education Disparity for Autism Spectrum Disorders in Taiwan Birth Cohort Study
Lung, F., Chiang, T., Lin, S.-J., & Shu, B. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2980-5 · Cited by 20 · see citing works
“Most screening tools have been evaluated in clinical samples referred for specialized assessment or in a mixture of clinical and population-based samples, but few researchers have examined the use of these screening tools in population-based studies (Beuker et al. 2014; Pandey et al. 2008; Robins 2008; Sternberg et al…”
Method
- Authors
- Robins, D. L.
- Affiliations
- Georgia State University (US)
- Corresponding author
- Robins, Diana L.
- ORCID
- Robins, Diana L.
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2008-09
- Volume
- 12
- Issue
- 5
- Pages
- 537-556
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- PMC
- PMC4732522
- OpenAlex
- W2158062042
- Cited by
- 239
- References
- 60
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 17 · 2021: 12 · 2020: 16 · 2019: 16 · 2018: 13 · 2017: 10 · 2016: 16 · 2015: 26 · 2014: 20 · 2013: 23 · 2012: 21
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R56HD035612)
- 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, autism screening, M-CHAT, primary care, toddlers, positive predictive value, screening tool, developmental delay
- MeSH terms
- Autistic Disorder, Child, Preschool, Female, Humans, Infant, Male, Mass Screening, Primary Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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