A new screening programme for autism in a general population of Swedish toddlers.
A 30-second nurse look at joint attention pushes M-CHAT accuracy to 90%.
01Research in Context
What this study did
Doctors in Sweden added a 30-second nurse check to the usual M-CHAT form.
The nurse watched if the toddler pointed or shared eye contact during the visit.
They ran this combo on toddlers coming in for routine 2- to 4-year shots.
What they found
Nine out of ten kids who failed both steps truly had ASD.
The short watch caught 48 of the 54 toddlers later diagnosed.
Fewer families had to come back for long tests.
How this fits with other research
Kara et al. (2014) got a lower hit rate in Turkey. They asked parents the M-CHAT questions out loud instead of handing over paper. That lifted accuracy to 75%, but the Swedish nurse glance pushed it even higher.
Xenitidis et al. (2010) showed that early joint-attention skills forecast later language in kids heading toward ASD. Gudrun’s team turns that idea into a quick screen.
Whiteside et al. (2022) taught parents to boost joint attention at home. The new study flips the lens: nurses simply watch for the skill to spot who needs help.
Why it matters
You already use the M-CHAT. Ask your nurse to note one thing: does the child point or look back to share a moment? That half-minute lifts your screen’s accuracy to 90%. Fewer false alarms mean families get to the right clinic faster and you spend less time on re-checks.
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02At a glance
03Original abstract
The evidence from early intervention studies of autism has emphasised the need for early diagnosis. Insight into the early presentation of autism is crucial for early recognition, and routine screening can optimise the possibility for early diagnosis. General population screening was conducted for 2.5-year-old children at child health centres in Gothenburg, Sweden, and the efficacy of the screening instruments in predicting a clinical diagnosis of autism was studied. The tools used for autism screening comprised the Modified Checklist for Autism in Children (M-CHAT) and an observation made by trained nurses of the child's joint attention abilities (JA-OBS). From the new screening procedure a "definitive" suspicion of autism spectrum disorder (ASD) was raised in 64 individuals in the study population of 3999 young children. Fifty-four of these were clinically assessed in detail. Forty-eight children had a confirmed diagnosis of ASD, three had severe language disorder, and three (6%) were classified as having typical development. The Positive predictive Value (PPV) for the combination of M-CHAT and the JA-OBS was 90%. The combination of instruments used showed promise for early detection of autism as a routine in the developmental programme at child health centres. Trained medical staff is a basic requirement and enables earlier detection and the use of screening tools beyond routine population screening regardless of the age at which a suspicion of autism is raised.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.02.018