The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Primary Care Autism Screening and Later Autism Diagnosis
Open accessAbstract
OBJECTIVES: To describe the proportion of children screened by the Modified Checklist for Autism in Toddlers (M-CHAT), identify characteristics associated with screen completion, and examine associations between autism spectrum disorder (ASD) screening and later ASD diagnosis. METHODS: We examined data from children attending 18- and 24-month visits between 2013 and 2016 from 20 clinics within a health care system for evidence of screening with the M-CHAT and subsequent coding of ASD diagnosis at age >4.75 years. We interviewed providers for information about usual methods of M-CHAT scoring and ASD referral. RESULTS: Of 36 233 toddlers, 73% were screened and 1.4% were later diagnosed with ASD. Hispanic children were less likely to be screened (adjusted prevalence ratio [APR]: 0.95, 95% confidence interval [CI]: 0.92–0.98), and family physicians were less likely to screen (APR: 0.12, 95% CI: 0.09–0.15). Compared with unscreened children, screen-positive children were more likely to be diagnosed with ASD (APR: 10.3, 95% CI: 7.6–14.1) and were diagnosed younger (38.5 vs 48.5 months, P < .001). The M-CHAT’s sensitivity for ASD diagnosis was 33.1%, and the positive predictive value was 17.8%. Providers routinely omitted the M-CHAT follow-up interview and had uneven referral patterns. CONCLUSIONS: A majority of children were screened for ASD, but disparities exist among those screened. Benefits for screen-positive children are improved detection and younger age of diagnosis. Performance of the M-CHAT can be improved in real-world health care settings by administering screens with fidelity and facilitating timely ASD evaluations for screen-positive children. Providers should continue to monitor for signs of ASD in screen-negative children.
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“Additionally, patients from minority groups in the United States are screened less often (Carbone et al., 2020; Guthrie et al., 2019; Zuckerman et al., 2013)”
From Navigating the Challenges: A Commentary on Barriers to Autism Screening in Childcare Centers (2026) · cites this paper as Carbone et al., 2020
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Identification and Evaluation of Children With Autism Spectrum Disorders
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Validation of the Modified Checklist for Autism in Toddlers, Revised With Follow-up (M-CHAT-R/F)
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The Lancet Commission on the future of care and clinical research in autism
Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., Carr, T., de Vries, P. J., Dissanayake, C., Divan, G., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)01541-5 · Cited by 924
Self-citationHadders‐Algra, M. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10040861 · Cited by 243
Aylward, B. S., Gal‐Szabo, D. E., & Taraman, S. (2021) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000996 · Cited by 241
Early detection of autism using digital behavioral phenotyping
Perochon, S., Martino, J. M. D., Carpenter, K. L. H., Compton, S. N., Davis, N. O., Eichner, B., Espinosa, S., Franz, L., Babu, P. R. K., Sapiro, G., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02574-3 · Cited by 141
Autism Diagnosis Among US Children and Adults, 2011-2022
Grosvenor, L. P., Croen, L., Lynch, F. L., Marafino, B. J., Maye, M. P., Penfold, R. B., Simon, G. E., & Ames, J. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.42218 · Cited by 143
Metadata
- Authors
- Carbone, P. S., Campbell, K., Wilkes, J., Stoddard, G. J., Huynh, K., Young, P. C., & Gabrielsen, T. P.
- Affiliations
- Departments of Pediatrics and
- Intermountain Healthcare (US)
- University of Utah (US)
- Brigham Young University (US)
- Corresponding author
- Carbone, Paul S.
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2020-08-01
- Volume
- 146
- Issue
- 2
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC7397730
- OpenAlex
- W3039245992
- Cited by
- 144
- References
- 29
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 27 · 2023: 26 · 2022: 26 · 2021: 25 · 2020: 8
- FWCI
- 11.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ScholarsArchive (Brigham Young University) (submittedVersion)
- Funders
- National Institutes of Health (5ul1tr001067-05, UL1TR002538, UL1TR000105)
- National Heart, Lung, and Blood Institute (R38HL143605)
- National Institute of Diabetes and Digestive and Kidney Diseases (R18DK123372)
- National Center for Research Resources (UL1RR025764)
- National Center for Advancing Translational Sciences (UL1-TR001067)
- 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, ASD diagnosis, screening sensitivity, positive predictive value, racial and ethnic disparities, Hispanic children, general practitioners, age at diagnosis
- MeSH terms
- Autism Spectrum Disorder, Child, Preschool, Female, Follow-Up Studies, Hispanic or Latino, Humans, Infant, Male, Mass Screening, Neuropsychological Tests, Predictive Value of Tests, Primary Health Care, Sensitivity and Specificity, Utah, Early Diagnosis, Healthcare Disparities, Checklist, Delayed Diagnosis
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