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Sociodemographic Barriers to Early Detection of Autism: Screening and Evaluation Using the M-CHAT, M-CHAT-R, and Follow-Up

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Abstract

Parents (n = 11,845) completed the Modified Checklist for Autism in Toddlers (or its latest revision) at pediatric visits. Using sociodemographic predictors of maternal education and race, binary logistic regressions were utilized to examine differences in autism screening, diagnostic evaluation participation rates and outcomes, and reasons for non-participation. Families of lower maternal education and racial minorities exhibited inflated initial screen positive rates and lower participation at Follow-Up, although not at the evaluation. Economic challenges, such as invalid phone numbers, were identified as barriers to reaching these families. Families of higher education and White race were more likely to decline participation in evaluation. Results suggest the need for increased public education about childhood development to enhance awareness, reduce stigma, and streamline screening.

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Notes

  1. The original M-CHAT and the revised M-CHAT-R are referred to together as M-CHAT(-R) throughout this article.

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Acknowledgments

We would like to thank our financial support sources, a joint Centers for Disease Control & Prevention and Georgia State University seed grant, as well as a research grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development, R01HD039961. Statistical consultation was provided by Lucy Robinson, Ph.D. (Drexel University) and Wing Yi Chan, Ph.D. (Georgia State University). We would also like to acknowledge the families who participated in the study, as well as the pediatricians who assisted by offering the M-CHAT(-R) questionnaire to their patients. Additionally, we are grateful for the time and effort put forth by the Developmental Neuropsychology Lab research staff involved in data collection for the project at Georgia State University. Data presented in the manuscript are a subset of a larger ongoing research study. Preliminary findings from the research presented in the enclosed manuscript were presented at a regional and international meeting, and have not been published elsewhere.

Conflict of interest

Diana Robins is co-owner of M-CHAT LLC, which licenses use of the M-CHAT in electronic products. However, data used in the current study were collected using the free version of the M-CHAT and no royalties are associated with this study.

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Authors and Affiliations

  1. Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA

    Meena K. Khowaja

  2. Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA, 30303, USA

    Ann P. Hazzard

  3. AJ Drexel Autism Institute, Drexel University, 3020 Market St., Suite 560, Philadelphia, PA, 19104, USA

    Diana L. Robins

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  1. Meena K. Khowaja
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Correspondence to Meena K. Khowaja.

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Khowaja, M.K., Hazzard, A.P. & Robins, D.L. Sociodemographic Barriers to Early Detection of Autism: Screening and Evaluation Using the M-CHAT, M-CHAT-R, and Follow-Up. J Autism Dev Disord 45, 1797–1808 (2015). https://doi.org/10.1007/s10803-014-2339-8

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