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J Dev Behav Pediatr. 2008 Oct;29(5):345-50. doi: 10.1097/DBP.0b013e31818914cf.

Screening strategies for autism spectrum disorders in pediatric primary care.

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  • 1Biobehavioral and Health Sciences Division, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA. pinto@nursing.upenn.edu

Abstract

BACKGROUND:

Two strategies have been proposed for early identification of children with autism spectrum disorders (ASD): (1) using a general screening tool followed by an ASD-specific screening tool for those who screen positive on the former or (2) using an ASD-specific tool for all children. The relative yield of these two strategies has not been examined.

OBJECTIVES:

This study compared the number of children identified at risk for ASD at their well child visits between the ages of 18 and 30 months using a general developmental screening tool and an autism-specific screening tool.

METHODS:

The Parents' Evaluation of Developmental Status (PEDS) was used as the general developmental screening tool and the Modified Checklist for Autism in Toddlers (M-CHAT) was used as the autism-specific tool. These tools were administered concurrently to 152 children.

RESULTS:

Cross tabulations and chi tests were used to determine the utility of the PEDS as the first step of a two-part screen for ASD. Of those who screened positive for developmental concerns on the PEDS (n = 38), 16% screened positive for ASD on the M-CHAT; of those who did not screen positive for developmental concerns on the PEDS (n = 114), 14% screened positive for ASD on the M-CHAT (p = .79).

CONCLUSION:

The PEDS missed the majority of children who screened positive for ASD on the M-CHAT, suggesting that these two tools tap into very different domains of developmental concerns. The findings support the use of an ASD-specific tool for all children in conjunction with regular standardized developmental screening.

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PMID:
18852608
[PubMed - indexed for MEDLINE]
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