Comparison of a broad-based screen versus disorder-specific screen in detecting young children with an autism spectrum disorder.
Pair M-CHAT with PEDS to catch autism without losing other delays.
01Research in Context
What this study did
The team compared two parent checklists used at 18-month check-ups. One was the M-CHAT, a 23-item autism screener. The other was PEDS, a broad developmental questionnaire.
Doctors gave both forms to parents of toddlers. They then watched which kids later got an autism diagnosis.
What they found
M-CHAT agreed with the final autism diagnosis more often than PEDS alone. Kids who slipped through the M-CHAT net often had early sensory issues or never pointed to share interest.
Using both tools together caught the most cases.
How this fits with other research
Kerub et al. (2020) saw the same pattern in Israeli clinics: M-CHAT/F caught 20% more autism cases than a broad screen while keeping false alarms low. The two studies line up like puzzle pieces.
Kamio et al. (2014) in Japan also found M-CHAT missed about half of toddlers later diagnosed, echoing the false-negative concern here.
Scarpa et al. (2013) looks like a clash: rural, low-income families had lots of M-CHAT false positives. The difference is setting and income, not the tool itself. In better-resourced practices the screen behaves well.
Why it matters
Run M-CHAT first to flag autism risk, then add PEDS to spot language or motor delays the first tool can miss. If a child passes M-CHAT but parents mention odd sensory habits or no pointing, keep watching and refer anyway. This two-step keeps you from both over-referring and missing early signs.
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02At a glance
03Original abstract
The goals of our study were to (a) compare agreement between autism spectrum disorder diagnosis and outcome of the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status in a sample of toddlers and (b) examine specific concerns noted for toddlers who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were later diagnosed with autism spectrum disorder. Participants were administered the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status during well-child visits. Families were invited for a clinical evaluation if autism spectrum disorder symptoms were noted on the Modified Checklist for Autism in Toddlers and Modified Checklist for Autism in Toddlers Follow-Up Interview or if autism spectrum disorder concerns were noted by the pediatrician. Fifty-two children completed the Modified Checklist for Autism in Toddlers, Parents Evaluation of Developmental Status, and a clinical evaluation, and 30 of these children were diagnosed with an autism spectrum disorder. Modified Checklist for Autism in Toddlers results showed higher agreement with autism spectrum disorder diagnosis than any individual Parents Evaluation of Developmental Status screen result, although the latter detected many children with other developmental concerns. Children who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were diagnosed with autism spectrum disorder had concerns noted in sensory response and proto-declarative pointing that can be considered in the context of screen results. In sum, our findings support universal autism spectrum disorder-specific screening in addition to general developmental screening and offer considerations to encourage early identification of toddlers with autism spectrum disorder.
Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361312466962