Autism can be detected in early childhood using a brief questionnaire

New research from the University of Cambridge suggests that autism can be detected at 18-30 months using the Quantitative Toddler Autism Checklist (Q-CHAT), but it It is not possible to identify every child at a young age who will later be diagnosed with autism. The results are published today in The BMJ Pediatric Open.

The Cambridge Autism Research Center team conducted a prospective population screening study of nearly 4,000 toddlers using a parenting reporting tool they developed, called the Quantitative Checklist for Autism in Toddlers (Q-CHAT). The toddlers were screened at 18 months and followed up at 4 years.

The Q-CHAT is a revision of the original CHAT first published by the same authors in the 1990s. It retains the key elements but includes additional elements that examine language development, repetitive and sensory behaviors, as well as other aspects of social communication behavior. Each of the 25 elements contains a range of response options, allowing approval of a reduced rate of key behaviors. In effect, this “sizes” each item (using a five-point frequency scale), allowing for variability in responses and a better understanding of the distributions between specific traits. The review was prompted by an attempt to improve the accuracy of autism screening in toddlers.

In the new research, during the first phase, 13,070 caregivers were asked to complete the Q-CHAT on their child aged 18 to 30 months. 3,770 caregivers referred the Q-CHAT, of which 121 were invited for a diagnostic assessment for autism.

In the second phase, the sample was followed up when the children were 4 years old, using the Childhood Autism Screening Test (CAST) and a checklist asking if any of children had been referred or diagnosed with developmental problems, including autism. Autism assessments were performed using internationally recognized methods.

The sensitivity (the proportion of children with autism correctly identified by the Q-CHAT as being autistic) of Q-CHAT in predicting autism in phase two is 44%, and the specificity (the proportion of children who are not are not autistic and who are correctly identified by the Q-CHAT as not being autistic) is 98%. The results also showed that the “positive predictive value” (the proportion of people who tested positive on the Q-CHAT who were found to be autistic) is 28%.

This study demonstrates that early detection and diagnosis of autism is possible using the Q-CHAT, since the 11 children classified as autistic scored at or above the cutoff of 39. The Q-CHAT does not. failed to identify all infants who were subsequently diagnosed with autism at age 4. This probably reflects the fact that some autistic children do not have symptoms severe enough until later in childhood.

In other studies, the team found that some people with autism are not diagnosed until adolescence or even adulthood, perhaps because family support alleviates the need for a diagnosis. social demands increase, for example during the transition to secondary school or the transition to adulthood.

Dr. Carrie Allison, director of research strategy at the Center for Autism Research and who led the study, says, “This study tells us that autism can be detected during toddlers and that other children cannot be identified as autistic until later. Repeated screening and monitoring throughout development may be a better approach rather than relying on a single point in time. “

Professor Tony Charman, professor of clinical child psychology at Kings College London and a member of the team, said that “testing infants for autism means that children can be stepped up to early intervention, which we know may lead to better results for This is an exciting advancement because most other toddler autism screening measures have not been studied in population studies rigorous of this type.

Professor Sir Simon Baron-Cohen, director of the Center for Autism Research and member of the team, said that “25 years ago our team was the first to show that autism can be detected. and diagnosed at the age of 18 months. This new study shows how our original screening instrument, the CHAT, has been transformed into a better instrument, the Q-CHAT, which can detect children who need a diagnosis. autism. Support. ”