Toddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy.
Ana B Sánchez-García, Purificación Galindo-Villardón, Ana B Nieto-Librero and 2 others
PMID 30617550WHAT IT FOUND
Pooled toddler autism screening tools identified 0.72 of children with ASD and cleared 0.98 of children without ASD.
A negative screen should not rule out autism.
Key findings
01Pooled accuracy across 18 sets of screening-test results was sensitivity 0.72 and specificity 0.98.
02Individual study sensitivities varied from 0.22 to 0.95, while specificities ranged from 0.81 to 0.99.
03A subgroup analysis that excluded studies that drove heterogeneity reported pooled sensitivity 0.77 and specificity 0.99.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Individual study sensitivity varied from 0.22 to 0.95, so pooled accuracy may not describe any one tool or setting. There was considerable heterogeneity in sensitivity and specificity across studies. 55% of included studies were assessed to have high or unclear risk of bias. Only 66.6% of studies provided all the primary outcomes needed to build 2 x 2 tables. The subgroup analysis excluded studies that drove heterogeneity, so its higher pooled values are not from the full set of included studies. The review was limited to English articles and screening ages of 14 to 36 months.
Declared interests
The supplied text names the US-ES Fulbright Commission as funder. It does not state author conflicts of interest.
The easy way to misread this
Do not read a negative screen as ruling out autism. The pooled sensitivity was 0.72, and individual study sensitivities ranged from 0.22 to 0.95.