Brief Report: Single and Repeat Screening with the Modified Checklist for Autism in Toddlers-Revised in Young Children at Higher Likelihood for Autism Spectrum Disorder.
Chandni Parikh, Sally Ozonoff
PMID 37906321WHAT IT FOUND
For toddlers with an older sibling with autism, screening twice (at 18 and 24 months) caught more true cases than screening once.
Parents with autism experience reported symptoms more consistently, so take their M-CHAT-R scores over the cutoff seriously and refer promptly.
Key findings
01Repeat screening at 18 and 24 months identified more true autism cases than single screening at 18 months alone.
02The M-CHAT-R showed high sensitivity and specificity in this higher-likelihood group, with positive predictive values ranging from 43% to 76%.
03Parents of children with an older sibling with autism showed stronger agreement between their reported concerns and M-CHAT-R scores than parents of lower-likelihood children.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
No M-CHAT-R follow-up interviews were conducted, which typically reduce false positives. The sample size was smaller than large community studies. Psychometric properties could not be directly compared between high and low likelihood groups because too few low-likelihood children developed autism. The study only included toddlers with an older sibling with autism, so results may not generalize to the general population without family history.
Declared interests
Funded by the Intellectual and Developmental Disabilities Research Center and the National Institute of Mental Health and Neurosciences. No other conflicts of interest reported.
The easy way to misread this
Do not assume these high accuracy rates apply to toddlers without a family history of autism. The positive predictive value was much higher in this high-risk group (43-76%) than in general population samples (14%), so screening performance may differ for children with typically developing siblings.