Universal Screening for Autism Feasible in Pediatric Network
Sensitivity of 38.8 percent found for M-CHAT/F; specificity lower in children of color, lower-income households
THURSDAY, Oct. 3, 2019 (HealthDay News) -- Universal screening for autism spectrum disorder (ASD) is feasible in a pediatric primary care network, according to a study published online Sept. 27 in Pediatrics.
Whitney Guthrie, Ph.D., from the Children's Hospital of Philadelphia, and colleagues examined the accuracy of universal screening with systematic follow-up through 4 to 8 years of age. The Modified Checklist for Autism in Toddlers with Follow-Up (M-CHAT/F) was used to perform universal primary care-based screening, supported by electronic administration and integration into electronic health records. Data were included for 25,999 children with a well-child visit at 16 to 26 months of age between January 2011 and July 2015.
The researchers found that nearly universal screening (91 percent) was achieved; the prevalence of ASD was 2.2 percent. The sensitivity of the M-CHAT/F was 38.8 percent, and the positive predictive value was 14.6 percent. Older toddlers had higher sensitivity, which was also seen with repeated screenings; girls had a lower positive predictive value. In children of color and those from lower-income households, the specificity and positive predictive value of the M-CHAT/F were lower.
"Results suggest that augmentative screening methods should be developed to detect more children through universal screening efforts and reduce disparities," the authors write. "However, any new method should be tested in cohorts that are universally screened and systematically followed-up to reduce the bias associated with screening and following selected populations."