Comparison of Available Tools to Screen for Autism at 12 and 15 Months.

No child was screened at both 12 and 15 months, so the comparison is between different groups, not the same children. The same tools were not used at every timepoint, so direct head-to-head comparison was limited. The number of children diagnosed with autism was small at each screening age, 29 after 12-month screening and 20 after 15-month screening, so confidence in tool-by-tool conclusions is limited. Many children who screened positive did not attend diagnostic evaluation, so their true diagnosis was unknown and positive predictive value could not be fully known. Children with negative screens were not confirmed as true negatives unless later concern arose, so some children diagnosed with autism later may not have been counted.

Some authors have ties to the tools studied. Drs. Robins, Barton, and Fein are co-owners of M-CHAT LLC, which receives royalties from commercial licensees of the M-CHAT, though the paper states no royalties were received for this study. Dr. Baranek is an author of the FYI, and the paper states the FYI is not commercially published and does not generate royalties. Dr. Robins serves on the program quality committee of Bancroft. The other authors declared no conflicts. No funding source is stated.

Do not treat a negative screen at 12 or 15 months as ruling out autism. Many children later diagnosed with autism screened negative at the first screen, and the authors say repeat screening at 18 months and beyond is essential.