Screening for Autism Spectrum Disorders

• Published in: American family physician Vol. 90; no. 8; pp. 574 - 575
• Main Authors: Grissom, Maureen, PhD, Tiffany, Matthew, MD, Davidson, Laurie, MLIS, MEd
• Format: Journal Article
• Language: English
• Published: Leawood American Academy of Family Physicians 15-10-2014
• Subjects: Autism; Children & youth; Internal Medicine; Pediatrics; Preschool children; Systematic review
• ISSN: 0002-838X

A systematic review included four cohort studies (N > 15,000 children) that evaluated the M-CHAT in screening for ASDs in low-risk children (defined as those screened during a routine visit, not in response to specific concerns or family history).1 The M-CHAT consists of 23 questions that the caregiver answers about the child's behavior. Without follow-up, the PPV ranged from 6% to 36%; the addition of the M-CHAT/F increased the PPV to 28% to 68%.1 A subsequent study of approximately 19,000 children reported a PPV of 6% for the M-CHAT alone and 54% for the M-CHAT/F.3 The same systematic review included five cohort studies (N = approximately 54,000 children) that evaluated the CHAT in screening for ASDs in low-risk children.1 The CHAT consists of nine questions for caregivers about the child's behavior and a 10- to 15-minute clinical examination. Of the two other tools noted in the survey,2 the Pervasive Developmental Disorders Screening Tool has not been extensively evaluated,4 and the Childhood Autism Rating Scale is more commonly used in children who are at increased risk of ASDs.5 Recommendations from Others The American Academy of Pediatrics Council on Children with Disabilities recommends screening all children for autism at 18 and 24 months using a validated autism screening tool, but it does not recommend a specific tool.6 Address correspondence to Maureen Grissom, PhD, at [e-mail].