Accurate Autism Screening at the 18-Month Well-Child Visit Requires Different Strategies than at 24 Months / Raymond STURNER in Journal of Autism and Developmental Disorders, 47-10 (October 2017)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 47-10 (October 2017) . - p.3296-3310 Titre : Accurate Autism Screening at the 18-Month Well-Child Visit Requires Different Strategies than at 24 Months Type de document : texte imprimé Auteurs : Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Tanya MORREL, Auteur ; Rebecca LANDA, Auteur ; Kejuana WALTON, Auteur ; Danielle MARKS, Auteur Article en page(s) : p.3296-3310 Langues : Anglais (eng) Mots-clés : Autism screening  Developmental screening  M-CHAT  Toddler development Index. décimale : PER Périodiques Résumé : Accuracy of autism screening using M-CHAT plus the follow-up interview (M-CHAT/F) for children screened positive at 18-months was compared to screening at 24-months. Formal ASD testing was criterion for a community sample of M-CHAT positive children (n = 98), positive predictive value (PPV) was 0.40 for the M-CHAT and 0.58 for the M-CHAT/F. MCHAT/F PPV was 0.69 among children 20+ months compared to 0.36 for <20 months. Multivariate analyses incorporating data from the Ages and Stages Questionnaire, MacArthur-Bates Communicative Development Inventory, M-CHAT and M-CHAT/F results, and M-CHAT items suggest language variables carry greatest relative importance in contributing to an age-based algorithm with potential to improve PPV for toddlers <20 months to the same level as observed in older toddlers. En ligne : https://doi.org/10.1007/s10803-017-3231-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=320 [article] Accurate Autism Screening at the 18-Month Well-Child Visit Requires Different Strategies than at 24 Months [texte imprimé] / Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Tanya MORREL, Auteur ; Rebecca LANDA, Auteur ; Kejuana WALTON, Auteur ; Danielle MARKS, Auteur . - p.3296-3310. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 47-10 (October 2017) . - p.3296-3310 Mots-clés : Autism screening  Developmental screening  M-CHAT  Toddler development Index. décimale : PER Périodiques Résumé : Accuracy of autism screening using M-CHAT plus the follow-up interview (M-CHAT/F) for children screened positive at 18-months was compared to screening at 24-months. Formal ASD testing was criterion for a community sample of M-CHAT positive children (n = 98), positive predictive value (PPV) was 0.40 for the M-CHAT and 0.58 for the M-CHAT/F. MCHAT/F PPV was 0.69 among children 20+ months compared to 0.36 for <20 months. Multivariate analyses incorporating data from the Ages and Stages Questionnaire, MacArthur-Bates Communicative Development Inventory, M-CHAT and M-CHAT/F results, and M-CHAT items suggest language variables carry greatest relative importance in contributing to an age-based algorithm with potential to improve PPV for toddlers <20 months to the same level as observed in older toddlers. En ligne : https://doi.org/10.1007/s10803-017-3231-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=320

Autism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners / Raymond STURNER in Molecular Autism, 13 (2022)  

Public ISBD [article]  inMolecular Autism > 13 (2022) . - 2p. Titre : Autism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners Type de document : texte imprimé Auteurs : Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Shana M. ATTAR, Auteur ; Lydia STEWART, Auteur ; Kerry BET, Auteur ; Carrie ALLISON, Auteur ; Simon BARON-COHEN, Auteur Article en page(s) : 2p. Langues : Anglais (eng) Mots-clés : Autism screening  Developmental screening  M-chat  Q-CHAT  Primary Care and its for-profit subsidiary,  CHADIS, Inc. CHADIS, the web-tool used  in the study was developed by Dr. Sturner and his spouse, Dr. Howard. Dr. Sturner is  Director of the Center and Dr. Howard is President of CHADIS, Inc. Both are members  of the Board of Directors of Center and are paid employees or consultants to both  entities. The other authors have indicated they have no financial relationships  relevant to this article to disclose. Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism screening is recommended at 18- and 24-month pediatric well visits. The Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) authors recommend a follow-up interview (M-CHAT-R/F) when positive. M-CHAT-R/F may be less accurate for 18-month-olds than 24-month-olds and accuracy for identification prior to two years is not known in samples that include children screening negative. Since autism symptoms may emerge gradually, ordinally scoring items based on the full range of response options, such as in the 10-item version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10), might better capture autism signs than the dichotomous (i.e., yes/no) items in M-CHAT-R or the pass/fail scoring of Q-CHAT-10 items. The aims of this study were to determine and compare the accuracy of the M-CHAT-R/F and the Q-CHAT-10 and to describe the accuracy of the ordinally scored Q-CHAT-10 (Q-CHAT-10-O) for predicting autism in a sample of children who were screened at 18 months. METHODS: This is a community pediatrics validation study with screen positive (n = 167) and age- and practice-matched screen negative children (n = 241) recruited for diagnostic evaluations completed prior to 2 years old. Clinical diagnosis of autism was based on results of in-person diagnostic autism evaluations by research reliable testers blind to screening results and using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) Toddler Module and Mullen Scales of Early Learning (MSEL) per standard guidelines. RESULTS: While the M-CHAT-R/F had higher specificity and PPV compared to M-CHAT-R, Q-CHAT-10-O showed higher sensitivity than M-CHAT-R/F and Q-CHAT-10. LIMITATIONS: Many parents declined participation and the sample is over-represented by higher educated parents. Results cannot be extended to older ages. CONCLUSIONS: Limitations of the currently recommended two-stage M-CHAT-R/F at the 18-month visit include low sensitivity with minimal balancing benefit of improved PPV from the follow-up interview. Ordinal, rather than dichotomous, scoring of autism screening items appears to be beneficial at this age. The Q-CHAT-10-O with ordinal scoring shows advantages to M-CHAT-R/F with half the number of items, no requirement for a follow-up interview, and improved sensitivity. Yet, Q-CHAT-10-O sensitivity is less than M-CHAT-R (without follow-up) and specificity is less than the two-stage procedure. Such limitations are consistent with recognition that screening needs to recur beyond this age. En ligne : http://dx.doi.org/10.1186/s13229-021-00480-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459 [article] Autism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners [texte imprimé] / Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Shana M. ATTAR, Auteur ; Lydia STEWART, Auteur ; Kerry BET, Auteur ; Carrie ALLISON, Auteur ; Simon BARON-COHEN, Auteur . - 2p. Langues : Anglais (eng) in Molecular Autism > 13 (2022) . - 2p. Mots-clés : Autism screening  Developmental screening  M-chat  Q-CHAT  Primary Care and its for-profit subsidiary,  CHADIS, Inc. CHADIS, the web-tool used  in the study was developed by Dr. Sturner and his spouse, Dr. Howard. Dr. Sturner is  Director of the Center and Dr. Howard is President of CHADIS, Inc. Both are members  of the Board of Directors of Center and are paid employees or consultants to both  entities. The other authors have indicated they have no financial relationships  relevant to this article to disclose. Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism screening is recommended at 18- and 24-month pediatric well visits. The Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) authors recommend a follow-up interview (M-CHAT-R/F) when positive. M-CHAT-R/F may be less accurate for 18-month-olds than 24-month-olds and accuracy for identification prior to two years is not known in samples that include children screening negative. Since autism symptoms may emerge gradually, ordinally scoring items based on the full range of response options, such as in the 10-item version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10), might better capture autism signs than the dichotomous (i.e., yes/no) items in M-CHAT-R or the pass/fail scoring of Q-CHAT-10 items. The aims of this study were to determine and compare the accuracy of the M-CHAT-R/F and the Q-CHAT-10 and to describe the accuracy of the ordinally scored Q-CHAT-10 (Q-CHAT-10-O) for predicting autism in a sample of children who were screened at 18 months. METHODS: This is a community pediatrics validation study with screen positive (n = 167) and age- and practice-matched screen negative children (n = 241) recruited for diagnostic evaluations completed prior to 2 years old. Clinical diagnosis of autism was based on results of in-person diagnostic autism evaluations by research reliable testers blind to screening results and using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) Toddler Module and Mullen Scales of Early Learning (MSEL) per standard guidelines. RESULTS: While the M-CHAT-R/F had higher specificity and PPV compared to M-CHAT-R, Q-CHAT-10-O showed higher sensitivity than M-CHAT-R/F and Q-CHAT-10. LIMITATIONS: Many parents declined participation and the sample is over-represented by higher educated parents. Results cannot be extended to older ages. CONCLUSIONS: Limitations of the currently recommended two-stage M-CHAT-R/F at the 18-month visit include low sensitivity with minimal balancing benefit of improved PPV from the follow-up interview. Ordinal, rather than dichotomous, scoring of autism screening items appears to be beneficial at this age. The Q-CHAT-10-O with ordinal scoring shows advantages to M-CHAT-R/F with half the number of items, no requirement for a follow-up interview, and improved sensitivity. Yet, Q-CHAT-10-O sensitivity is less than M-CHAT-R (without follow-up) and specificity is less than the two-stage procedure. Such limitations are consistent with recognition that screening needs to recur beyond this age. En ligne : http://dx.doi.org/10.1186/s13229-021-00480-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459

Comparison of Autism Screening in Younger and Older Toddlers / Raymond STURNER in Journal of Autism and Developmental Disorders, 47-10 (October 2017)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 47-10 (October 2017) . - p.3180-3188 Titre : Comparison of Autism Screening in Younger and Older Toddlers Type de document : texte imprimé Auteurs : Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Lydia STEWART, Auteur ; Talin E. AFARIAN, Auteur Article en page(s) : p.3180-3188 Langues : Anglais (eng) Mots-clés : Autism screening  M-CHAT  Developmental screening  Test development Index. décimale : PER Périodiques Résumé : This study examined the effect of age at completion of an autism screening test on item failure rates contrasting older (>20 months) with younger (<20 months) toddlers in a community primary care sample of 73,564 children. Items related to social development were categorized into one of three age sets per criteria from Inada et al. (Research in Autism Spectrum Disorders 4(4):605–611, 2010). Younger toddlers produced higher rates of item failure than older toddlers and items in both of the later acquired item sets had higher probability rates for failure than the earliest acquired item set (prior to 8 months). Use of the same items and the same scoring throughout the target age range for autism screening may not be the best strategy for identifying the youngest toddlers at risk for autism. En ligne : https://doi.org/10.1007/s10803-017-3230-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=319 [article] Comparison of Autism Screening in Younger and Older Toddlers [texte imprimé] / Raymond STURNER, Auteur ; Barbara HOWARD, Auteur ; Paul BERGMANN, Auteur ; Lydia STEWART, Auteur ; Talin E. AFARIAN, Auteur . - p.3180-3188. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 47-10 (October 2017) . - p.3180-3188 Mots-clés : Autism screening  M-CHAT  Developmental screening  Test development Index. décimale : PER Périodiques Résumé : This study examined the effect of age at completion of an autism screening test on item failure rates contrasting older (>20 months) with younger (<20 months) toddlers in a community primary care sample of 73,564 children. Items related to social development were categorized into one of three age sets per criteria from Inada et al. (Research in Autism Spectrum Disorders 4(4):605–611, 2010). Younger toddlers produced higher rates of item failure than older toddlers and items in both of the later acquired item sets had higher probability rates for failure than the earliest acquired item set (prior to 8 months). Use of the same items and the same scoring throughout the target age range for autism screening may not be the best strategy for identifying the youngest toddlers at risk for autism. En ligne : https://doi.org/10.1007/s10803-017-3230-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=319

Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value? / Raymond STURNER in Journal of Autism and Developmental Disorders, 53-8 (August 2023)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 53-8 (August 2023) . - p.3065-3076 Titre : Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value? Type de document : texte imprimé Auteurs : Raymond STURNER, Auteur ; Paul BERGMANN, Auteur ; Barbara HOWARD, Auteur ; Kerry BET, Auteur ; Lydia STEWART-ARTZ, Auteur ; Shana M. ATTAR, Auteur Article en page(s) : p.3065-3076 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n 167) and age, gender, and practice-matched children passing screens (n 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development. En ligne : https://doi.org/10.1007/s10803-022-05541-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=508 [article] Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value? [texte imprimé] / Raymond STURNER, Auteur ; Paul BERGMANN, Auteur ; Barbara HOWARD, Auteur ; Kerry BET, Auteur ; Lydia STEWART-ARTZ, Auteur ; Shana M. ATTAR, Auteur . - p.3065-3076. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 53-8 (August 2023) . - p.3065-3076 Index. décimale : PER Périodiques Résumé : Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n 167) and age, gender, and practice-matched children passing screens (n 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development. En ligne : https://doi.org/10.1007/s10803-022-05541-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=508

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