Autism Detection in Early Childhood (ADEC) in a Low-Income Spanish-Speaking Population in Guayaquil (Ecuador).

Families volunteered, so parents already worried about development may have been more likely to attend, which can change the number of detected cases. ADOS-2 was applied only to children suspected by risk or positive screening, not to all 613 children, so the true number of missed or false cases is not fully known. The study did not follow up children to confirm false positives or false negatives, especially below 24 months. The 3.75% figure cannot be treated as a reliable population prevalence because Ecuadorian prevalence is unknown and the sample was not general. The screening pathway used several instruments together, including Bayley-III, MCHAT-R/F, ADEC, ADOS-2, and clinical judgment, so the effect of any single step cannot be isolated. The sample came from low-income Guayaquil centers, so results may not apply to other socioeconomic strata or regions.

The ADEC adaptation was part of a project approved by Ecuador's Ministry of Economic and Social Inclusion, and the larger project was approved by Universitat de València ethics committee. The supplied text does not report author competing interests.

Do not conclude that the ADEC-GU can be used alone to detect autism in this population. It missed 4 of the 23 children diagnosed with autism, and the study did not follow up false positives or false negatives.