Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an Urban Metropolitan Sample of Young Children in Turkey.
Ozgur Oner, Kerim M Munir
PMID 31414260WHAT IT FOUND
The Turkish M-CHAT-R/F identified 9.8% of toddlers as screen-positive, but only 3.3% remained positive after follow-up interviews.
High-risk children (score 8-20) rarely needed follow-up, suggesting they could be referred directly for evaluation to save resources.
Key findings
01Nearly 10% of children screened positive initially, but the two-stage process (follow-up interview) reduced the false-positive rate significantly, leaving 3.3% of the total sample still positive.
02Children with high-risk scores (8-20) on the initial screen were almost always (96.6%) still positive after follow-up, suggesting the follow-up interview may be unnecessary for this group in low-resource settings.
03Parents with lower education and socioeconomic status had higher initial screen-positive rates, but these differences disappeared after follow-up interviews, indicating the follow-up stage helps correct for comprehension issues.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a feasibility pilot in urban primary care centers, not a representative epidemiological sample. Clinical evaluations were not completed for all children who screened positive, so the true prevalence and negative predictive value cannot be fully determined. Only 15 children who screened positive initially but negative on follow-up were evaluated, making the calculation of false negatives unreliable. The study did not compare individual practitioner performance, so variability in screening quality among the 148 practitioners is unknown.
Declared interests
The study was supported by the Istanbul Development Agency and conducted with the TOHUM Autism Foundation, Istanbul Metropolitan Municipality, and local health and education directorates. Authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the 0.8% prevalence rate as the true community rate for autism in Turkey. This figure comes from a specific urban sample with incomplete follow-up for all screen-positives and is not representative of the general population.