A Comparison Between Two Screening Approaches for ASD Among Toddlers in Israel
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Systematic screening of autism spectrum disorder (ASD) can improve early diagnosis of ASD. We compared the efficacy of two ASD screening methods, the Global Developmental Screening (GDS), and the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up (M-CHAT/F) in 1591 toddlers of ages 18–36 months from 35 government-funded clinics in south Israel. The M-CHAT/F performed better than the GDS in detecting toddlers with ASD (sensitivity: 70.0% vs. 50.0%, and specificity: 98.2% vs. 96.6% respectively). Both methods had an equivalent performance in detecting other forms of developmental delays (sensitivity = 63%; and specificity ~ 98%). In addition, remarkable inter-nurse variation was observed in the GDS referral decisions. Thus, employment of the M-CHAT/F in the Israeli health system may improve early detection of ASD among toddlers.
KeywordsAutism spectrum disorder Screening Toddlers M-CHAT
We would like to thank to all the nurses at the maternal child health centers that participated in this study. This research was supported by Grant No. 527/15 from the Israeli Science Foundation (ISF).
OK conceived of the study, participated in its design and coordination, performed the statistical analysis, and drafted the manuscript; EJH helped in the interpretation of the data and drafted the manuscript; GM participated in the design and coordination of the study and made all patient diagnoses; ND conceived of the study and participated in the design and coordination of the study; IM conceived of the study, participated in its design and coordination, oversaw the statistical analysis and draft the manuscript. All authors read and approved the final manuscript.
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- Bin Nun, G., Berlovitz, Y., Shani, M. (2010). The Health Care System in Israel, (2nd ed.), Tel Aviv: Am Oved Publishers Ltd.Google Scholar
- Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 580–587. https://doi.org/10.1016/j.jaac.2015.04.005.CrossRefPubMedPubMedCentralGoogle Scholar
- Israel Ministry of Health. (2016). Guidance for the assessing of developmental assessments for infants and toddlers up to the age of six years.Google Scholar
- Kamio, Y., Inada, N., Koyama, T., Inokuchi, E., Tsuchiya, K., & Kuroda, M. (2014). Effectiveness of using the Modified Checklist for Autism in toddlers in two-stage screening of autism spectrum disorder at the 18-month health check-up in Japan. Journal of Autism and Developmental Disorders, 44, 194–203. https://doi.org/10.1007/s10803-013-1864-1.CrossRefPubMedGoogle Scholar
- Kleinman, J. M., 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, 827–839. https://doi.org/10.1007/s10803-007-0450-9.CrossRefPubMedPubMedCentralGoogle Scholar
- Nygren, G., Sandberg, E., Gillstedt, F., Ekeroth, G., Arvidsson, T., & Gillberg, C. (2012). A new screening programme for autism in a general population of Swedish toddlers. Research in Developmental Disabilities, 33, 1200–1210. https://doi.org/10.1016/j.ridd.2012.02.018.CrossRefPubMedGoogle Scholar
- Pinto-Martin, J. A., Young, L. M., Mandell, D. S., Poghosyan, L., Giarelli, E., & Levy, S. E. (2008). Screening strategies for autism spectrum disorders in pediatric primary care. Journal of Developmental and Behavioral Pediatrics, 29, 345–350. https://doi.org/10.1097/DBP.0b013e31818914cf.CrossRefPubMedGoogle Scholar
- The Central Bureau of Statistics of Israel. (2016). Live birth statistics. Statistical abstract of Israel.Google Scholar
- Worley, J. A., Matson, J. L., Mahan, S., Kozlowski, A. M., & Neal, D. (2011). Stability of symptoms of autism spectrum disorders in Toddlers: An examination using the Baby and Infant Screen for Children with aUtIsm Traits-Part 1 (BISCUIT). Developmental Neurorehabilitation, 14, 36–40. https://doi.org/10.3109/17518423.2010.530638.CrossRefPubMedGoogle Scholar