A Commentary to “Toddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy”

  • Roald A. ØienEmail author
  • Domenic V. Cicchetti
  • Anders Nordahl-Hansen
  • Synnve Schjølberg
Letter to the Editor

Over the past decade, the debate surrounding the value of screening instruments have increased, and while some findings support the use of screening instruments, other studies raise critical questions regarding the efficiency of such instruments (Baird et al. 2011; McPheeters et al. 2016; Siu et al. 2016; UK National Screening Committee 2012).

Firstly, it is important to state that this commentary is not intended as a critique of the meta-analysis by Sánchez-García et al. (2019). It is of great importance and conducted with a rigorous meta-analytic approach that provides us with important knowledge of how screening instruments perform across various studies. The systematic search is comprehensive. It includes a combination of broad and narrow search strategies as well as searching through the grey literature. The authors use advanced fitting statistics deploying a Bayesian hierarchical model procedure as well as control for publication bias.

However, the authors of this letter to the...


Author Contributions

RAØ, DVC, ANH, SS have contributed equally to this manuscript.


The authors have no financial relationships relevant to this article to disclose.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose.


  1. Baird, G., Douglas, H. R., & Murphy, M. S. (2011). Recognising and diagnosing autism in children and young people: Summary of NICE guidance. BMJ, 343(oct21 1), d6360. Scholar
  2. Øien, R. A., Schjølberg, S., Volkmar, F. R., Shic, F., Cicchetti, D. V., Nordahl-Hansen, A., et al. (2018). Clinical features of children with autism who passed 18-month screening. Pediatrics, 141, e20173596. Scholar
  3. 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(2), 131–144. Scholar
  4. Sánchez García, A. B., Galindo-Villardón, P., Nieto-Librero, A. B., Martín-Rodero, H., & Robins, D. L. (2019). Toddler screening for autism spectrum disorder: A meta-analysis of diagnostic accuracy. Journal of Autism and Developmental Disorders, 49(5), 1837–1852. Scholar
  5. Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., et al. (2016). Screening for autism spectrum disorder in young children: US preventive services task force recommendation statement. JAMA, 315(7), 691–696. Scholar
  6. Stein, M. B., & Norman, S. B. (2019). When does meta-analysis of a network not work?: Fishing for answers. JAMA Psychiatry, 76(9), 885–886. Scholar
  7. Stenberg, N., Bresnahan, M., Gunnes, N., Hirtz, D., Hornig, M., Lie, K. K., et al. (2014). Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatric and Perinatal Epidemiology, 28(3), 255–262. Scholar
  8. Surén, P., Saasen-Havdahl, A., Bresnahan, M., Hirtz, D., Hornig, M., Lord, C., et al. (2019). Sensitivity and specificity of early screening for autism. BJPsych Open, 5(3), e41. Scholar
  9. UK National Screening Committee. (2012). Screening for autistic spectrum disorders in children under the age of five policy position statement and summary. Retrieved July 3, 2017, from
  10. McPheeters, M. L., Weitlauf, A., Vehorn, A., Taylor, C., Sathe, N. A., Krishnaswami, S., et al. Screening for Autism Spectrum Disorder in Young Children. Agency for Healthcare Research and Quality.Google Scholar

Copyright information

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

Authors and Affiliations

  1. 1.Department of EducationUiT - The Arctic University of NorwayTromsøNorway
  2. 2.Child Study Center, Yale School of MedicineYale UniversityNew HavenUSA
  3. 3.Faculty of Education, Østfold University CollegeHaldenNorway
  4. 4.Department of child Health and DevelopmentNorwegian Institute of Public HealthOsloNorway

Personalised recommendations