According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 59 kids has an autism spectrum disorder (ASD). Finding these children and identifying them as soon as possible can be the key to helping them reach the best possible outcome. Unfortunately, a new study shows that the most widely used screening tool for ASD in toddlers is less accurate than previous research showed.
Pediatricians use a tool called the Modified Checklist for Autism in Toddlers with Follow-Up, or MCHAT/F, for screening children for early warning signs of autism. It’s a two-part parent survey administered during kids’ 18- and 24-month checkup visits. The goal of this screening is to identify children who may need early intervention and make sure they are receiving autism services as early as possible.
A study done by Children’s Hospital of Philadelphia (CHOP) and published in the journal Pediatrics found that, of all the children who went on to later be diagnosed with ASD, only 40 percent had been identified by the MCHAP/F as showing signs of autism. Further findings in the study showed that children of color and children living in urban or low-income neighborhoods were even less likely to be correctly identified by the screening tool. Children who were not screened at all were disproportionately from these populations, as well. They also found that the screening was less accurate for girls.
These findings are alarming, to put it mildly. Identifying and treating children with autism as early as possible is key to their future success. According to Whitney Guthrie, PhD and lead author of the study, “Early intervention has been shown to improve outcomes, potentially into adulthood. We know that early and accurate screening and diagnosis is the crucial first step in helping children access those effective, autism-specific therapies.”
Kate Wallis, MD, MPH, co-author of the study and developmental pediatrician and researcher at CHOP’s PolicyLab, shared, “This study revealed important limitations and provides us with new knowledge that we can use to make critical improvements to autism screening tools and screening processes, so pediatricians can properly detect and support more children with autism and reduce disparities in diagnosis and care.”
The good news is, the researchers also found that 91 percent of children had been screened, which is close to the universal screening that’s recommended. Further, children who screened positive for symptoms of ASD were diagnosed seven months sooner than kids who tested negative. So the tool, while flawed, can definitely be effective in getting kids those critical interventions earlier.
As autism rates continue to rise, we are moving in the right direction by ensuring pediatricians regularly use the MCHAT/F to screen every child they see before the age of two. However, much more research is needed to pinpoint how to make these screenings most accurate. Not only do we need to make sure they are identifying children as soon as possible, but we need to make sure they are identifying all children as early as possible. Every child with ASD, regardless of race, sex or family income level deserves the chance to grow up to be the best they can be.
