Adaptation of the "ten questions" to screen for autism and other neurodevelopmental disorders in Uganda.
A simple 23-question parent screener reliably flags autism risk in Ugandan toddlers when fancy tools aren't an option.
01Research in Context
What this study did
Researchers in Uganda added 13 autism questions to the classic Ten Questions screener.
They tested the new 23-item tool in 1,200 households with kids aged 18 months to 5 years.
Local health workers asked parents the questions during routine home visits.
What they found
The screener caught 55-a large share of children later diagnosed with autism or or other delays.
It worked best for kids with clear delays and missed some higher-functioning cases.
Parents answered all questions in under 10 minutes with no training needed.
How this fits with other research
Marsack-Topolewski et al. (2025) shows a new AI screener hits 97-a large share accuracy, far above Uganda's 55-a large share.
But the AI tool needs tablets and internet—things Uganda's paper form doesn't need.
Jones et al. (2007) found the SCQ catches 93-a large share of US kids, yet needs clinic visits.
van den Broek et al. (2006) shows M-CHAT also misses higher-functioning kids, just like Uganda's tool.
Why it matters
If you work in low-resource areas, this 23-question form gives you a quick first pass.
Use it during home visits or school screenings to spot kids who need full tests.
The tool is free, needs no gear, and takes minutes—perfect when specialists are scarce.
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02At a glance
03Original abstract
Neurodevelopmental disorders are recognized to be relatively common in developing countries but little data exist for planning effective prevention and intervention strategies. In particular, data on autism spectrum disorders are lacking. For application in Uganda, we developed a 23-question screener (23Q) that includes the Ten Questions screener and additional questions on autism spectrum disorder behaviors. We then conducted household screening of 1169 children, 2-9 years of age, followed by clinical assessment of children who screened positive and a sample of those who screened negative to evaluate the validity of the screener. We found that 320 children (27% of the total) screened positive and 68 children received a clinical diagnosis of one or more moderate to severe neurodevelopmental disorders (autism spectrum disorder; cerebral palsy; epilepsy; cognitive, speech and language, hearing, or vision impairment), including 8 children with autism spectrum disorders. Prevalence and validity of the screener were evaluated under different statistical assumptions. Sensitivity of the 23Q ranged from 0.55 to 0.80 and prevalence for ≥1 neurodevelopmental disorders from 7.7/100 children to 12.8/100 children depending on which assumptions were used. The combination of screening positive on both autism spectrum disorders and Ten Questions items was modestly successful in identifying a subgroup of children at especially high risk of autism spectrum disorders. We recommend that autism spectrum disorders and related behavioral disorders be included in studies of neurodevelopmental disorders in low-resource settings to obtain essential data for planning local and global public health responses.
Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361313475848