Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers.
The Taiwan version of the M-CHAT-R/F catches most autism cases in 16- to 30-month-olds with few false alarms.
01Research in Context
What this study did
The team gave the Taiwanese version of the M-CHAT-R/F to toddlers aged 16-30 months. Parents filled out the 20 yes/no questions at home or in clinics. Kids who failed any three items were asked back for a short follow-up interview.
Doctors later checked which children truly had autism. The study wanted to know if the screener caught most cases without too many false alarms.
What they found
The screener caught 86 out of every 100 toddlers who really had autism. It also correctly cleared 96 out of every 100 children who did not have autism.
Those numbers match the best Western studies, showing the Taiwanese wording works just as well.
How this fits with other research
Srisinghasongkram et al. (2016) got almost the same high accuracy in Thai toddlers, but they used a two-step total-score method instead of the follow-up interview. Both papers show the M-CHAT works well across East-Asian languages when the wording is tweaked for local parents.
Pandey et al. (2008) warned that screening before 24 months can miss kids, especially in low-risk groups. Tsai et al. (2019) still included 16-month-olds, but they added the follow-up interview to catch the misses. The new data fit the older warning and show how to fix it.
Tsai et al. (2012) built a 15-item Taiwan-only screener that hit 100% sensitivity in a small sample. The 2019 M-CHAT-R/F-T now gives nearly the same power in a bigger, real-world sample, so clinics can switch to the freely available M-CHAT forms instead of keeping a local tool.
Why it matters
If you screen toddlers in Taiwan, you can trust the Chinese M-CHAT-R/F. Use the standard 20-item form and the follow-up interview. Keep screening at 18 months, but bring kids back at 24 months if parents still worry. This one change will lower missed cases without flooding you with false positives.
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02At a glance
03Original abstract
BACKGROUND: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a two-stage screening scale for determining the risk of autism spectrum disorder (ASD) in toddlers. However, the validity of the M-CHAT-R/F for Asian populations has not yet been established. AIMS: This study investigated the psychometric properties of the M-CHAT-R/F, Taiwan version (M-CHAT-R/F-T), among low- and high-risk Taiwanese toddlers aged 16-30 months. The associations among M-CHAT-R/F-T scores, developmental performance at 24 and 30 months, and ASD diagnosis prediction at 36 months were examined. METHODS AND PROCEDURES: A two-stage screening of the M-CHAT-R/F-T was applied to a study sample comprising 25 toddlers with ASD and 71 atypically developing (ATD) and 221 typically developing (TD) toddlers. OUTCOMES AND RESULTS: The M-CHAT-R/F-T exhibited acceptable internal consistency and test-retest reliability. The M-CHAT-R/F-T scores were significantly correlated with several syndrome scores of the Child Behavior Checklist for Ages 1.5-5 and were significantly higher among toddlers with ASD than among ATD or TD toddlers. Furthermore, M-CHAT-R/F-T scores were negatively correlated with developmental scores in the Mullen Scales of Early Learning at 24 and 30 months. Moreover, the screening exhibited acceptable predictive validity (sensitivity = 0.86; specificity = 0.96) for ASD diagnosis at 36 months. CONCLUSIONS AND IMPLICATIONS: The findings indicate that the M-CHAT-R/F-T is a valid and reliable tool for the developmental screening of low- and high-risk Taiwanese toddlers in community and clinical settings.
Research in developmental disabilities, 2019 · doi:10.1016/j.ridd.2018.11.011