Short caregiver interview and play observation for early screening of autism spectrum disorder: Behavior development screening for toddlers (BeDevel).
A 25-minute caregiver interview plus play observation spots autism risk in toddlers with high accuracy and no tech needed.
01Research in Context
What this study did
The team built a new toddler screener called BeDevel. It has two parts: a 10-minute caregiver interview and a 15-minute play observation.
They tested 18- to 42-month-olds with autism, other delays, and typical kids. They wanted to see if BeDevel could flag autism risk quickly.
What they found
BeDevel caught 85-92 % of kids later diagnosed with autism. It also ruled out autism correctly 77-97 % of the time.
That means the tool is both sensitive and specific — rare for a 25-minute screen.
How this fits with other research
Older screeners like M-CHAT and SCQ (C et al. 2006, W et al. 2007) caught fewer kids and missed higher-functioning toddlers. BeDevel adds a play module and raises accuracy.
A 2025 ML screener (N et al. 2025) claims 97-99 % accuracy with just a questionnaire. That looks like a leap forward, but it needs tablets and data. BeDevel still wins in low-tech settings.
Kremkow et al. (2022) reviewed digital tools and found most are still prototypes. BeDevel is already validated and ready for clinics today.
Why it matters
If you run an early-intervention clinic, you can add BeDevel to your intake. A 25-minute screen saves weeks of wait lists and gets kids into ABA faster.
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02At a glance
03Original abstract
This study validates behavior development screening for toddlers (BeDevel), which utilizes a combination of short caregiver interviews (BeDevel-I) and semistructured play observations (BeDevel-P). The data of 431 toddlers (male 66.2%; mean age (SD) = 29.11 (8.59) months; ASD, n = 201; developmental delay, n = 46; typically developing, n = 184), aged 18 ~ 42 months, were included in the validation of BeDevel. The best clinical estimate diagnosis, screening rate, validity, sensitivity, and reliability of BeDevel were determined based on data cross-sectionally collected using BeDevel and existing diagnostic/screening instruments: autism diagnostic observation schedule (ADOS), autism diagnostic interview (ADI-R), Vineland adaptive behavior scales-II (VABS-II), social response scales (SRS), sequenced language scale for infants (SELSI), Korean childhood autism rating scale (K-CARS), and Korean social communication questionnaire (K-SCQ). The k values of BeDevel-I and BeDevel-P were 0.055 ~ 0.732 and 0.291 ~ 0.752, respectively. Items related to social referencing in BeDevel-P had a particularly high diagnostic validity (k = 0.483 ~ 0.684). Reliabilities of BeDevel-I and BeDevel-P were sufficient (Cronbach's alpha = 0.86 ~ 0.88 and 0.92 ~ 0.95, respectively). BeDevel-I and BeDevel-P showed high sensitivity (BeDevel-I: 85.00 ~ 89.29%; BeDevel-P: 85.00 ~ 91.75%), specificity (BeDevel-I: 77.55 ~ 89.55%; BeDevel-P: 85.09 ~ 97.01%), PPV (BeDevel-I: 70.83 ~ 88.54%; BeDevel-P: 81.52 ~ 94.68%), and NPV (BeDevel-I: 76.00 ~ 95.24%; BeDevel-P: 84.62 ~ 95.45%). The agreement between the composite BeDevel score and ADOS, ADI-R, K-CARS, and K-SCQ was >67.6% (range = 67.6 ~ 90.8%). Combining a short caregiver interview and direct play observation is a valid and reliable screening process. More studies on social referencing as an important early marker are needed. BeDevel can be utilized as a secondary screening instrument before diagnostic confirmation in clinical and community settings. LAY SUMMARY: BeDevel, which consists of a short caregiver interview and direct play observation, is a valid and reliable screening instrument for autism spectrum disorder (ASD). We suggest that BeDevel can be utilized as a secondary instrument before administering diagnostic assessments in clinical and community settings. More studies examining social referencing as a potential behavioral marker of ASD are needed.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2510