Journal of Autism and Developmental Disorders

, Volume 49, Issue 11, pp 4674–4680 | Cite as

Brief Report: Replication and Validation of the Brief Autism Detection in Early Childhood (BADEC) in a Clinical Sample

  • Rose E. NevillEmail author
  • Darren Hedley
  • Mirko Uljarević
Brief Report


We investigated the clinical validity of the BADEC, an abbreviated, five-item version of the Autism Detection in Early Childhood, level-2 screening tool for autism. Initially developed by Nah et al. (2019) using a research sample, the present study replicated Nah et al. (2019) procedures in a clinical population. Using a cutoff score of five, five items were identified as most effective in discriminating children who later received an ASD diagnosis by an interdisciplinary team. This algorithm had improved validity compared to the original research algorithm. Results supported the efficacy of a very brief, easy to administer ASD screening tool in identifying children under three who are likely to have ASD.


Screening Diagnosis Toddlers Clinical performance Pediatricians Wellness checks 



This research was supported by Nationwide Children’s Hospital Clinical and Translational Intramural Grant #203213 awarded to Darren Hedley. The researchers would like to thank Associate Professor Dr. Robyn Young and Dr. Yong-Hwee Nah of Flinders University, Australia, for assistance with the development of a training protocol for the ADEC and for reviewing training tapes. We particularly thank the staff at the Child Development Center at Nationwide Children’s Hospital, Columbus, Ohio, and those children and families who participated in this study. We also thank Brianna Murphy, Sarah Beinkampen, and Emily Mariotti for their assistance with data collection.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  2. Barbaro, J., & Dissanayake, C. (2013). Early markers of autism spectrum disorders in infants and toddlers prospectively identified in the Social Attention and Communication Study. Autism: The International Journal of Research and Practice, 17, 64–86.CrossRefGoogle Scholar
  3. Biao, J., Wiggins, L., & Christensen, D. L. (2018). Prevalence of autism spectrum disorder among children aged 8 years: Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(SS-6), 1–23.CrossRefGoogle Scholar
  4. Cassel, T. D., Messinger, D. S., Ibanez, L. V., Haltigan, J. D., Acosta, S. I., & Buchman, A. C. (2007). Early social and emotional communication in the infant siblings of children with autism spectrum disorders: An examination of the broad phenotype. Journal of Autism and Developmental Disorders, 37, 122–132.CrossRefGoogle Scholar
  5. Chawarska, K., Klin, A., Paul, R., & Volkmar, F. (2007). Autism spectrum disorder in the second year: Stability and change in syndrome expression. Journal of Child Psychology and Psychiatry, 48, 128–138.CrossRefGoogle Scholar
  6. Glascoe, F. P. (2005). Screening for developmental and behavioral problems. Mental Retardation and Developmental Disabilities Research Reviews, 11, 173–179.CrossRefGoogle Scholar
  7. Goldstein, S., & Naglieri, J. A. (2009). Autism spectrum rating scales. New York: Pearson.Google Scholar
  8. Gura, G. F., Champagne, M. T., & Blood-Siegfried, J. E. (2011). Autism spectrum disorder screening in primary care. Journal of Developmental and Behavioral Pediatrics, 32, 48.CrossRefGoogle Scholar
  9. Havdahl, K. A., Bishop, S. L., Surén, P., Øyen, A.-S., Lord, C., Pickles, A., …, Stoltenberg, C. (2017). The influence of parental concern on the utility of autism diagnostic instruments. Autism Research, 10, 1672–1686Google Scholar
  10. Hedley, D., Nevill, R. E., Monroy-Moreno, Y., Fields, N., Wilkins, J., Butter, E., et al. (2015). Efficacy of the ADEC in identifying autism spectrum disorder in clinically referred toddlers in the US. Journal of Autism and Developmental Disorders, 45, 2337–2348.CrossRefGoogle Scholar
  11. Hedley, D., Young, R., Angelica, M., Gallegos, J., & Salazar, C. M. (2010). Cross-cultural evaluation of the autism detection in early childhood (ADEC) in Mexico. Autism, 14, 93–112.CrossRefGoogle Scholar
  12. Johnson, C. P., & Myers, S. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5), 1183–1215.CrossRefGoogle Scholar
  13. Keil, A., Breunig, C., Fleischfresser, S., & Oftedahl, E. (2014). Promoting routine use of developmental and autism-specific screening tools by pediatric primary care clinicians. Wisconsin Medical Journal, 113, 227–231.Google Scholar
  14. Lord, C., Luyster, R. J., Gotham, K., & Guthrie, W. (2012). Autism diagnostic observation schedule, second edition (ADOS-2) manual (Part II): Toddler module. Torrance, CA: Western Psychological Services.Google Scholar
  15. Mullen, E. (1995). Mullen scales of early learning (AGS ed.). Circle Pines, MN: American Guidance Service.Google Scholar
  16. Nah, Y.-H., Young, R. L., & Brewer, N. (2014a). Using the autism detection in early childhood (ADEC) and childhood autism rating scales (CARS) to predict long term outcomes in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(9), 2301–2310.CrossRefGoogle Scholar
  17. Nah, Y.-H., Young, R. L., & Brewer, N. (2019). Development of a brief version of the autism detection in early childhood. Autism, 23, 494–502.CrossRefGoogle Scholar
  18. Nah, Y.-H., Young, R. L., Brewer, N., & Berlingeri, G. (2014b). Autism Detection in Early Childhood (ADEC): Reliability and validity data for a level 2 screening tool for autistic disorder. Psychological Assessment, 26, 215–226.CrossRefGoogle Scholar
  19. Rice, M. E., & Harris, G. T. (2005). Comparing effect sizes in follow-up studies: ROC Area, Cohen’s d, and r. Law and Human Behavior, 29, 615–620.CrossRefGoogle Scholar
  20. Robins, D. L., Fein, D., & Barton, M. (2009). The Modified Checklist for Autism in Toddlers, Revised, with Follow-up. (M-CHAT-R/F). Self-published. Retrieved from
  21. Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2010). Childhood autism rating scale (2nd ed.). Torrance, CA: Western Psychological Services.Google Scholar
  22. Stone, W., Coonrod, E., & Ousley, O. (2000). Brief report: Screening tool for autism in two-year-olds (stat): development and preliminary data. Journal of Autism and Developmental Disorders, 30, 607.CrossRefGoogle Scholar
  23. Tchaconas, A., & Adesman, A. (2017). Diagnostic evaluation of children with autism spectrum disorders: Clinician compliance with published guidelines. Journal of Developmental and Behavioral Pediatrics, 38, 29.CrossRefGoogle Scholar
  24. WebMD Health Professional Network. (2018). Medscape Physician Compensation Report 2018. New York, NY: Medscape, LLC. Retrieved from//
  25. Wiggins, L. D., & Robins, D. L. (2008). Brief report: Excluding the ADI-R behavioral domain improves diagnostic agreement in toddlers. Journal of Autism and Developmental Disorders, 38, 972–976.CrossRefGoogle Scholar
  26. Young, R. (2007). Autism detection in early childhood (ADEC) manual. Camberwell: ACER Press.Google Scholar
  27. Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., …, Wagner, S. (2015). Early screening of autism spectrum disorder: Recommendations for practice and research. Pediatrics, 136, 41–59Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Rose E. Nevill
    • 1
    • 2
    • 3
    Email author
  • Darren Hedley
    • 1
    • 4
  • Mirko Uljarević
    • 5
    • 6
  1. 1.Nationwide Children’s HospitalColumbusUSA
  2. 2.Ohio State UniversityColumbusUSA
  3. 3.Curry School of Education and Human DevelopmentUniversity of VirginiaCharlottesvilleUSA
  4. 4.Olga Tennison Autism Research Centre, La Trobe UniversityBundooraAustralia
  5. 5.Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordUSA
  6. 6.School of Psychological SciencesThe University of MelbourneMelbourneAustralia

Personalised recommendations