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Journal of Autism and Developmental Disorders

, Volume 44, Issue 2, pp 405–416 | Cite as

The Clinical Utility of the Modified Checklist for Autism in Toddlers with High Risk 18–48 Month Old Children in Singapore

  • Hwan Cui KohEmail author
  • Si Huan Lim
  • Gifford Jiguang Chan
  • Marisa Bilin Lin
  • Hong Huay Lim
  • Sylvia Henn Tean Choo
  • Iliana Magiati
Original Paper

Abstract

The modified checklist for autism in toddlers (M-CHAT) is a tool developed for 16–30 month old children to screen for autism spectrum disorders (ASD). It is a well-researched tool, but little is known about its utility with Singaporean toddlers and with older children referred for developmental concerns. This study investigated the M-CHAT’s performance with 18–30 month old (N = 173) and >30–48 month old (N = 407) developmentally at-risk Singaporean children, when used with three recommended scoring methods i.e., the total, critical and Best7 scoring methods. The results indicate that the critical and Best7 scoring methods detected most true cases of ASD without inflating the false positive rates in toddlers, and that only the total scoring method performed acceptably for the older children.

Keywords

Autism spectrum disorders Screening Early identification M-CHAT Level 2 screening High risk children 

Notes

Acknowledgments

We acknowledge Charissa Wong who participated in data collection for the study. We would like to thank Tang Hui Nee, Yang Phey Hong, and Cheong Wan Mui, who provided valuable advice during the course of the research. Special mention also goes to Jennifer Tan, Suraya Amir, and other administrative staff of the Department of Child Development, KK Women’s and Children’s Hospital, who kindly assisted with the data collection process.

References

  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
  2. Bayley, N. (2006). Bayley Scales of Infant and Toddler Development. San Antonio, TX: The Psychological Corporation.Google Scholar
  3. Canal-Bedia, R., García-Primo, P., Martín-Cilleros, M. V., Santos-Borbujo, J., Guisuraga-Fernández, Z., Herráez-García, L., et al. (2011). Modified checklist for autism in toddlers: Cross-cultural adaptation and validation in Spain. Journal of Autism and Developmental Disorders, 41(10), 1342–1351.PubMedCrossRefGoogle Scholar
  4. Department of Statistics, Singapore. (2012). Population trends 2012. Retrieved 29 May 2013, from Statistics Singapore website: http://www.singstat.gov.sg/.
  5. Eaves, L. C., Wingert, H., & Ho, H. H. (2006). Screening for autism: Agreement with diagnosis. Autism, 10, 229–242.PubMedCrossRefGoogle Scholar
  6. Elliott, C. D. (2007). Differential ability scales (2nd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
  7. Fawcett, T. (2006). An introduction to ROC analysis. Pattern Recognition Letters, 27(8), 861–874.CrossRefGoogle Scholar
  8. George, D., & Mallery, P. (2003). SPSS for windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon.Google Scholar
  9. Glascoe, F. P. (2005). Screening for developmental and behavioural problems. Mental Retardation and Developmental Disabilities Research Reviews, 11(3), 173–179.PubMedCrossRefGoogle Scholar
  10. Inada, N., Koyama, T., Inokuchi, E., Kuroda, M., & Kamio, Y. (2010/2011). Reliability and validity of the Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT). Research in Austism Spectrum Disorders, 5(1), 330–336.Google Scholar
  11. Kleinman, J. M., Robins, D. L., Ventola, P. E., Pandey, J., Boorstein, H. C., Esser, E. L., et al. (2008). The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(5), 827–839.PubMedCentralPubMedCrossRefGoogle Scholar
  12. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr, Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.PubMedCrossRefGoogle Scholar
  13. Lung, F.-W., Chiang, T.-L., Lin, S.-J., & Shu, B.-C. (2011). Autism-risk screening in the first 3 years of life in Taiwan Birth Cohort Pilot Study. Research in Autism Spectrum Disorders, 5(4), 1385–1389.CrossRefGoogle Scholar
  14. Magiati, I., Tay, X. W., & Howlin, P. (2012). Early comprehensive behaviourally based interventions for children with autism spectrum disorders: A summary of findings from recent reviews and meta-analyses. Neuropsychiatry, 2(6), 543–570.CrossRefGoogle Scholar
  15. Norris, M., & Lecavalier, L. (2010). Screen accuracy of level 2 autism spectrum disorder rating scales. A review of selected instruments. Autism, 14, 263–284.PubMedCrossRefGoogle Scholar
  16. Pandey, J., Verbalis, A., Robins, D., Boorstein, H., Klin, A., Babitz, T., et al. (2008). Screening for autism in older and younger toddlers with the modified checklist for autism in toddlers. Autism, 12(5), 513–535.PubMedCrossRefGoogle Scholar
  17. Perera, H., Wijewardena, K., & Aluthwelage, R. (2009). Screening of 18–24-month-old children for autism in a semi-urban community in Sri Lanka. Journal of Tropical Pediatrics, 55(6), 402–405.PubMedCrossRefGoogle Scholar
  18. Robins, D. L. (2008). Screening for autism spectrum disorders in primary care settings. Autism, 12(5), 537–556.PubMedCrossRefGoogle Scholar
  19. Robins, D. L., & Dumont-Mathieu, T. (2006). Early screening for autism spectrum disorders: Update on the modified checklist for autism in toddlers and other measures. Journal of Developmental & Behavioural Pediatrics, 27(Supplement 2), S111–S119.CrossRefGoogle Scholar
  20. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144.PubMedCrossRefGoogle Scholar
  21. Robins, D. L., Pandey, J., Chlebowski, C., Carr, K., Zaj, J. L., Arroyo, M., Barton, M. L., Green, J., & Fein, D. A. (2010, May). M-CHAT Best7: A new scoring algorithm improves positive predictive power of the M-CHAT. Paper presented at the International Meeting for Autism Research (IMFAR) in Philadelphia, USA.Google Scholar
  22. Seif Eldin, A., Habib, D., Noufal, A., Farrag, S., Bazaid, K., Al-Sharbati, M., et al. (2008). Use of M-CHAT for a multinational screening of young children with autism in the Arab countries. International Review of Psychiatry, 20(3), 281–289.PubMedCrossRefGoogle Scholar
  23. Snow, A. V., & Lecavalier, L. (2008). Sensitivity and specificity of the modified checklist for autism in toddlers and the social communication questionnaire in preschoolers suspected of having pervasive developmental disorders. Autism, 12(6), 627–644.PubMedCrossRefGoogle Scholar
  24. Sparrow, S. S., Cicchetti, D., & Balla, D. (2005). Vineland adaptive behavior scales-II. Circle Pines, MN: American Guidance Service.Google Scholar
  25. Wallis, K. E., & Pinto-Martin, J. (2008). The challenge of screening for autism spectrum disorder in a culturally diverse society. Acta Paediatrica, 97(5), 539–540.PubMedCrossRefGoogle Scholar
  26. Weschler, D. (2002). Wechsler preschool and primary scale of intelligence (3rd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
  27. Wong, V., Hui, L. H., Lee, W. C., Leung, L. S., Ho, P. K., Lau, W. L., et al. (2004). A modified screening tool for autism (checklist for autism in toddlers [CHAT-23]) for Chinese children. Pediatrics, 114(2), e166–e176.PubMedCrossRefGoogle Scholar
  28. Woolfenden, S., Sarkozy, V., Riddley, G., & Williams, K. (2012). A systematic review of the diagnostic stability of autism spectrum disorder. Research in Autism Spectrum Disorders, 6(1), 345–354.CrossRefGoogle Scholar
  29. Yama, B., Freeman, T., Graves, E., Yuan, S., & Campbell, K. (2012). Examination of the properties of the modified checklist for autism in toddlers (M-CHAT) in a population sample. Journal of Autism and Developmental Disorders, 42, 23–34.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hwan Cui Koh
    • 1
    Email author
  • Si Huan Lim
    • 2
  • Gifford Jiguang Chan
    • 2
  • Marisa Bilin Lin
    • 2
  • Hong Huay Lim
    • 1
  • Sylvia Henn Tean Choo
    • 1
  • Iliana Magiati
    • 2
  1. 1.Department of Child DevelopmentKK Women’s and Children’s HospitalSingaporeSingapore
  2. 2.Department of PsychologyNational University of SingaporeSingaporeSingapore

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