Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments / Andrea Trubanova WIECKOWSKI in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2898-2905 Titre : Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments Type de document : texte imprimé Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; Ashley B. DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley H. DUBIN, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.2898-2905 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments [texte imprimé] / Andrea Trubanova WIECKOWSKI, Auteur ; Ashley B. DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley H. DUBIN, Auteur ; Diana L. ROBINS, Auteur . - p.2898-2905. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2898-2905 Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Autism Screening in High-Likelihood Children in a Community Early Intervention Setting: A Hybrid Effectiveness-Implementation Study / Georgina PEREZ LIZ in Focus on Autism and Other Developmental Disabilities, 40-3 (September 2025)  

Public ISBD [article]  inFocus on Autism and Other Developmental Disabilities > 40-3 (September 2025) . - p.145-153 Titre : Autism Screening in High-Likelihood Children in a Community Early Intervention Setting: A Hybrid Effectiveness-Implementation Study Type de document : texte imprimé Auteurs : Georgina PEREZ LIZ, Auteur ; Diana THAO, Auteur ; Katelyn REEB, Auteur ; Ilene GOY, Auteur ; Erin E. MCCURDY, Auteur ; Michael YUDELL, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.145-153 Langues : Anglais (eng) Mots-clés : autism  autism screening  M-CHAT-R/F  early intervention  community setting  effectiveness-implementation Index. décimale : PER Périodiques Résumé : Identification of likelihood for autism in the U.S. early intervention (EI) system facilitates referrals to diagnostic assessments and targets autism-specific needs. However, performance of autism screeners in high-likelihood preschool children and barriers to implementation need to be further studied. The current effectiveness-implementation hybrid type 1 study examined the impact of administering the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) in a sample of preschool children during the EI intake phone call. Data from 2,661 educational records showed that 42.8% of them received the M-CHAT-R. Only 14.0% of the screen-positive children completing the process to determine eligibility for EI services were referred for an autism-specific evaluation. Most of these (94.8%), regardless of screener status, received an autism diagnosis, suggesting that referrals are based on clinical judgment. Training and incorporation to current protocols within agencies are necessary to introduce a screening tool and support implementation fidelity and effective autism detection. En ligne : https://dx.doi.org/10.1177/10883576241308544 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566 [article] Autism Screening in High-Likelihood Children in a Community Early Intervention Setting: A Hybrid Effectiveness-Implementation Study [texte imprimé] / Georgina PEREZ LIZ, Auteur ; Diana THAO, Auteur ; Katelyn REEB, Auteur ; Ilene GOY, Auteur ; Erin E. MCCURDY, Auteur ; Michael YUDELL, Auteur ; Diana L. ROBINS, Auteur . - p.145-153. Langues : Anglais (eng) in Focus on Autism and Other Developmental Disabilities > 40-3 (September 2025) . - p.145-153 Mots-clés : autism  autism screening  M-CHAT-R/F  early intervention  community setting  effectiveness-implementation Index. décimale : PER Périodiques Résumé : Identification of likelihood for autism in the U.S. early intervention (EI) system facilitates referrals to diagnostic assessments and targets autism-specific needs. However, performance of autism screeners in high-likelihood preschool children and barriers to implementation need to be further studied. The current effectiveness-implementation hybrid type 1 study examined the impact of administering the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) in a sample of preschool children during the EI intake phone call. Data from 2,661 educational records showed that 42.8% of them received the M-CHAT-R. Only 14.0% of the screen-positive children completing the process to determine eligibility for EI services were referred for an autism-specific evaluation. Most of these (94.8%), regardless of screener status, received an autism diagnosis, suggesting that referrals are based on clinical judgment. Training and incorporation to current protocols within agencies are necessary to introduce a screening tool and support implementation fidelity and effective autism detection. En ligne : https://dx.doi.org/10.1177/10883576241308544 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566

Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input / Georgina PEREZ LIZ ; Ashley B. DE MARCHENA ; Deborah A. FEIN ; Marianne L. BARTON ; Giacomo VIVANTI ; Diana L. ROBINS in Autism, 28-12 (December 2024)  

Public ISBD [article]  inAutism > 28-12 (December 2024) . - p.3033-3042 Titre : Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input Type de document : texte imprimé Auteurs : Georgina PEREZ LIZ, Auteur ; Ashley B. DE MARCHENA, Auteur ; Deborah A. FEIN, Auteur ; Marianne L. BARTON, Auteur ; Giacomo VIVANTI, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.3033-3042 Langues : Anglais (eng) Mots-clés : autism screening  Delphi poll  measure development  school-age Index. décimale : PER Périodiques Résumé : Universal autism screening is recommended by the American Academy of Pediatrics at 18 and 24 months. However, many children are not identified until after the age of 4 years, and some not until adulthood, either due to mild or no indication of symptoms early in development, or to co-occurring conditions which may overshadow autism symptoms. This indicates a need for universal autism screening measures for school-age children. This project adapts the widely used toddler autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), for use in school-age children, called M-CHAT-School (M-CHAT-S). The study follows the Patient-Reported Outcomes Measurement Information System guidelines for measure development to create parent- and teacher-report versions of the M-CHAT-S for 4- to 8-year-old children. Through expert consensus feedback via a Delphi pool and cognitive interviewing with stakeholders (i.e. parents and teachers), we developed two versions of the M-CHAT-S to be used for verbal and minimally verbal children. The M-CHAT-S poses several advantages to existing measures, including brevity, items updated based on current knowledge and conventions, and narrow age range to assure items are developmentally appropriate. Future steps include validation of the M-CHAT-S to determine its utility as an autism screener for young school-age children. Lay abstract The American Academy of Pediatrics recommends universal screening to identify children at higher likelihood for autism at 18- and 24-month well-child visits. There are many children, however, that are missed during this toddler age who do not get diagnosed until much later in development, delaying access to autism-specific interventions. Currently, brief measures for universal autism screening for school-age children, however, are lacking. In this project, we adapted a commonly used autism screener for toddlers, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), to be used for school-age children. This measure, called the M-CHAT-School (M-CHAT-S), is a parent- and teacher-report questionnaire to be used to screen for autism in school-age children aged 4 to 8 years of age. M-CHAT-S was developed through feedback from autism experts, as well as interviews with parents and teachers to provide input on the items. Two versions of M-CHAT-S were developed, one for verbally fluent and one for minimally verbal school-age children. M-CHAT-S is a brief measure, with updated items to reflect changes in the way experts think and talk about autism, making it a useful measure to use for autism screening in elementary aged children. The next steps include further testing to ensure that M-CHAT-S performs well in identifying children with increased likelihood of autism, after which it will be made available to parents, educators, and other professionals. En ligne : https://dx.doi.org/10.1177/13623613241252312 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543 [article] Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input [texte imprimé] / Georgina PEREZ LIZ, Auteur ; Ashley B. DE MARCHENA, Auteur ; Deborah A. FEIN, Auteur ; Marianne L. BARTON, Auteur ; Giacomo VIVANTI, Auteur ; Diana L. ROBINS, Auteur . - p.3033-3042. Langues : Anglais (eng) in Autism > 28-12 (December 2024) . - p.3033-3042 Mots-clés : autism screening  Delphi poll  measure development  school-age Index. décimale : PER Périodiques Résumé : Universal autism screening is recommended by the American Academy of Pediatrics at 18 and 24 months. However, many children are not identified until after the age of 4 years, and some not until adulthood, either due to mild or no indication of symptoms early in development, or to co-occurring conditions which may overshadow autism symptoms. This indicates a need for universal autism screening measures for school-age children. This project adapts the widely used toddler autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), for use in school-age children, called M-CHAT-School (M-CHAT-S). The study follows the Patient-Reported Outcomes Measurement Information System guidelines for measure development to create parent- and teacher-report versions of the M-CHAT-S for 4- to 8-year-old children. Through expert consensus feedback via a Delphi pool and cognitive interviewing with stakeholders (i.e. parents and teachers), we developed two versions of the M-CHAT-S to be used for verbal and minimally verbal children. The M-CHAT-S poses several advantages to existing measures, including brevity, items updated based on current knowledge and conventions, and narrow age range to assure items are developmentally appropriate. Future steps include validation of the M-CHAT-S to determine its utility as an autism screener for young school-age children. Lay abstract The American Academy of Pediatrics recommends universal screening to identify children at higher likelihood for autism at 18- and 24-month well-child visits. There are many children, however, that are missed during this toddler age who do not get diagnosed until much later in development, delaying access to autism-specific interventions. Currently, brief measures for universal autism screening for school-age children, however, are lacking. In this project, we adapted a commonly used autism screener for toddlers, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), to be used for school-age children. This measure, called the M-CHAT-School (M-CHAT-S), is a parent- and teacher-report questionnaire to be used to screen for autism in school-age children aged 4 to 8 years of age. M-CHAT-S was developed through feedback from autism experts, as well as interviews with parents and teachers to provide input on the items. Two versions of M-CHAT-S were developed, one for verbally fluent and one for minimally verbal school-age children. M-CHAT-S is a brief measure, with updated items to reflect changes in the way experts think and talk about autism, making it a useful measure to use for autism screening in elementary aged children. The next steps include further testing to ensure that M-CHAT-S performs well in identifying children with increased likelihood of autism, after which it will be made available to parents, educators, and other professionals. En ligne : https://dx.doi.org/10.1177/13623613241252312 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543

Preliminary Reliability and Validity of the M-CHAT-S, a New Autism Screening Tool for School-Aged Children / Ashley DE MARCHENA in Autism, 30-9 (September 2026)  

Public ISBD [article]  inAutism > 30-9 (September 2026) . - p.2248-2259 Titre : Preliminary Reliability and Validity of the M-CHAT-S, a New Autism Screening Tool for School-Aged Children Type de document : texte imprimé Auteurs : Ashley DE MARCHENA, Auteur ; Andrea T. WIECKOWSKI, Auteur ; Alexia F. DICKERSON, Auteur ; Hunter S. CHENG, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley DUBIN, Auteur ; Giacomo VIVANTI, Auteur ; Marianne BARTON, Auteur ; Deborah FEIN, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.2248-2259 Langues : Anglais (eng) Mots-clés : autism  screening  early detection  psychometrics Index. décimale : PER Périodiques Résumé : Identifying autism early is critical for ensuring timely access to appropriate educational and clinical supports. Current autism screening practices primarily focus on toddlers; universal practices for identifying the substantial portion of autistic children who arrive at school age without a diagnosis are lacking. This study evaluates the preliminary reliability and validity of the Modified Checklist for Autism in Toddlers–School Age version (M-CHAT-S), a novel screener designed for early school-age children, with separate versions for verbally fluent and minimally verbal children. A total of 165 caregivers and 107 educators completed the M-CHAT-S, along with the Social Responsiveness Scale, Second Edition (SRS-2), to test convergent validity, and the Child Behavior Checklist (CBCL), to test discriminant validity. Findings demonstrate strong internal consistency across versions (Cronbach’s α = .79–.92) and robust construct validity. Children with preexisting autism diagnoses scored higher on the M-CHAT-S than nonautistic children. Both test–retest reliability and interrater reliability were in the moderate range. Despite these limitations, the M-CHAT-S demonstrates promise as a screening tool that could facilitate earlier identification of autistic children in school settings. Future research will involve a partnership with school districts to support school-based validation and implementation.Lay Abstract Children with disabilities have a right to a free and appropriate public education in the United States. Children who are not identified by the time of school entry are likely to miss out on appropriate services and supports to which they would otherwise be legally entitled. Many studies show that a large portion of individuals who are ultimately diagnosed with autism are not identified until by the time they start school.Screening tools can help identify children who may be on the autism spectrum. Universal autism screening is currently recommended for toddlers, but not school-age children. To address this gap, we developed the Modified Checklist for Autism in Toddlers-School Age version (M-CHAT-S) for children in early elementary school. This study tested the consistency and accuracy of the M-CHAT-S for both verbally fluent and minimally verbal children.We asked 165 caregivers and 107 educators to complete the M-CHAT-S and compared their responses to other well-established measures of autism traits and behavior. Overall, we found that the M-CHAT-S had good reliability, meaning that the items in the measure were consistent with each other. Children with a known autism diagnosis scored higher on the M-CHAT-S than non-autistic children. M-CHAT-S scores were more strongly related to another autism screening tool (the SRS-2) than to a survey of general behavior (the CBCL). However, test-retest reliability (whether the same rater’s score stayed consistent over time) and interrater reliability (whether two different raters agreed on scores) were lower than expected.These results suggest that the M-CHAT-S may be a useful tool for identifying autistic children in early school years. Future research will involve partnering with school districts to be able to reach as many children as possible, including autistic children who have not yet been identified. If validated further, this tool could help schools and families recognize children who need autistic support, leading to earlier access to services. En ligne : https://dx.doi.org/10.1177/13623613261464200 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=592 [article] Preliminary Reliability and Validity of the M-CHAT-S, a New Autism Screening Tool for School-Aged Children [texte imprimé] / Ashley DE MARCHENA, Auteur ; Andrea T. WIECKOWSKI, Auteur ; Alexia F. DICKERSON, Auteur ; Hunter S. CHENG, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley DUBIN, Auteur ; Giacomo VIVANTI, Auteur ; Marianne BARTON, Auteur ; Deborah FEIN, Auteur ; Diana L. ROBINS, Auteur . - p.2248-2259. Langues : Anglais (eng) in Autism > 30-9 (September 2026) . - p.2248-2259 Mots-clés : autism  screening  early detection  psychometrics Index. décimale : PER Périodiques Résumé : Identifying autism early is critical for ensuring timely access to appropriate educational and clinical supports. Current autism screening practices primarily focus on toddlers; universal practices for identifying the substantial portion of autistic children who arrive at school age without a diagnosis are lacking. This study evaluates the preliminary reliability and validity of the Modified Checklist for Autism in Toddlers–School Age version (M-CHAT-S), a novel screener designed for early school-age children, with separate versions for verbally fluent and minimally verbal children. A total of 165 caregivers and 107 educators completed the M-CHAT-S, along with the Social Responsiveness Scale, Second Edition (SRS-2), to test convergent validity, and the Child Behavior Checklist (CBCL), to test discriminant validity. Findings demonstrate strong internal consistency across versions (Cronbach’s α = .79–.92) and robust construct validity. Children with preexisting autism diagnoses scored higher on the M-CHAT-S than nonautistic children. Both test–retest reliability and interrater reliability were in the moderate range. Despite these limitations, the M-CHAT-S demonstrates promise as a screening tool that could facilitate earlier identification of autistic children in school settings. Future research will involve a partnership with school districts to support school-based validation and implementation.Lay Abstract Children with disabilities have a right to a free and appropriate public education in the United States. Children who are not identified by the time of school entry are likely to miss out on appropriate services and supports to which they would otherwise be legally entitled. Many studies show that a large portion of individuals who are ultimately diagnosed with autism are not identified until by the time they start school.Screening tools can help identify children who may be on the autism spectrum. Universal autism screening is currently recommended for toddlers, but not school-age children. To address this gap, we developed the Modified Checklist for Autism in Toddlers-School Age version (M-CHAT-S) for children in early elementary school. This study tested the consistency and accuracy of the M-CHAT-S for both verbally fluent and minimally verbal children.We asked 165 caregivers and 107 educators to complete the M-CHAT-S and compared their responses to other well-established measures of autism traits and behavior. Overall, we found that the M-CHAT-S had good reliability, meaning that the items in the measure were consistent with each other. Children with a known autism diagnosis scored higher on the M-CHAT-S than non-autistic children. M-CHAT-S scores were more strongly related to another autism screening tool (the SRS-2) than to a survey of general behavior (the CBCL). However, test-retest reliability (whether the same rater’s score stayed consistent over time) and interrater reliability (whether two different raters agreed on scores) were lower than expected.These results suggest that the M-CHAT-S may be a useful tool for identifying autistic children in early school years. Future research will involve partnering with school districts to be able to reach as many children as possible, including autistic children who have not yet been identified. If validated further, this tool could help schools and families recognize children who need autistic support, leading to earlier access to services. En ligne : https://dx.doi.org/10.1177/13623613261464200 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=592

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