Improving Early Identification and Access to Diagnosis of Autism Spectrum Disorder in Toddlers in a Culturally Diverse Community with the Rapid Interactive screening Test for Autism in Toddlers.

The study was small and took place in one early-intervention program in Worcester, Massachusetts, so it may not apply to other settings. The wait-time comparison was not a randomised control: toddlers in the model were compared with toddlers referred outside the model, so other differences between referrals could explain the shorter wait. A RITA-T score above 16 was associated with autism in this sample, but some toddlers later diagnosed with autism had scores below 16, so the screen cannot rule out autism on its own. The paper reports a 100% positive predictive value at a score of 16 or higher, but also says one toddler with a score of 16 was diagnosed as non-ASD/DD. The study measured screening accuracy and wait time, not later child outcomes. The authors were involved in the diagnostic process, although they state that investigators were blinded to screening results. The paper reports 81 toddlers analysed, but also says it enrolled 12 toddlers with no ASD concerns; the relationship of those 12 to the analysed groups is unclear.

Funding was named from the University of Massachusetts Medical School and the Fairlawn Foundation. The supplied text gives no additional conflict-of-interest declaration.

Do not treat the RITA-T as a diagnostic test or as proof that early screening improves autism outcomes. It was a screening step in a small demonstration study, and some toddlers later diagnosed with autism had scores below 16. The authors still say expert clinical judgement is essential.