Brief Report: Use of the Infant-Toddler Checklist in Infant Siblings of Children with Autism Spectrum Disorder.
Chandni Parikh, Ana-Maria Iosif, Sally Ozonoff
PMID 32219636WHAT IT FOUND
The Infant-Toddler Checklist missed many cases in high-risk siblings, with sensitivity below accepted levels.
Accuracy improved by 24 months, but positive predictive value remained low. Clinicians should interpret early screening results cautiously in this population.
Key findings
01Sensitivity and specificity for detecting any delay were below the generally accepted 80% threshold, though they improved over time.
02When used specifically to detect ASD, sensitivity was 77% and specificity 85% at 24 months, but positive predictive value was only 55%.
03Screening accuracy was weakest in the first year of life and improved with age, consistent with the gradual emergence of symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The results may not generalize to the general population because the sample was enriched with high-risk siblings. Sample sizes for some age points were small relative to typical screening studies. The study relied on a specific cutoff (bottom 10th percentile) which may not reflect how all clinicians interpret scores.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not treat a negative Infant-Toddler Checklist score in the first year of life as evidence that a high-risk child is free of autism or communication delay. The test missed nearly half of the affected children in this age range.