Autism spectrum disorder screening in preschools.
Angel Hoe-Chi Au, Kathy Kar-Man Shum, Yongtian Cheng and 4 others
PMID 33153314WHAT IT FOUND
A 13-item classroom checklist, rated by preschool teachers or briefly trained observers, flagged children who were later more likely to meet ASD criteria.
It is a screening aid, not a diagnosis.
Key findings
01A 13-item Classroom Observation Scale was reduced from an 84-item checklist, with 10 items focused on peer interaction.
02Children who later met ASD criteria had lower teacher and researcher COS scores than children who did not.
03Using a bottom 15% cutoff, children flagged by teachers or researchers were more likely to have ASD about 1.5 years later.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 82 children were clinically assessed, while 322 children were observed. The number of missed ASD cases among unassessed screen-negative children is unknown. The diagnosed ASD group was small, with 14 children. The odds ratio confidence intervals were wide, so accuracy estimates are uncertain. The bottom 15% cutoff was a first approximation, not an established clinical cutoff. The sample came from English-speaking international preschools in Hong Kong. These preschools served middle to middle-upper socioeconomic families, so the results may not generalise to other preschool populations. Teacher and researcher ratings agreed only moderately (r = 0.55). Different observers may identify different children. The ASD assessment occurred about 1.5 years after observation. The COS predicted later diagnosis. It did not diagnose ASD at the time of observation.
Declared interests
The authors disclosed receipt of financial support from the Research Grants Council of Hong Kong (HKU 740213) and the Karen Lo Eugene Chuang Professorship in Diversity and Equity.
The easy way to misread this
Do not use the COS as a diagnosis. It flagged children who were later more likely to meet ASD criteria, but only 14 children among the 82 assessed were diagnosed. The cutoffs were exploratory, and the authors say they are only references for now.