Advertisement

A Comparison Between Two Screening Approaches for ASD Among Toddlers in Israel

  • Orly Kerub
  • Eric J. Haas
  • Gal Meiri
  • Nadav Davidovitch
  • Idan Menashe
Original Paper

Abstract

Systematic screening of autism spectrum disorder (ASD) can improve early diagnosis of ASD. We compared the efficacy of two ASD screening methods, the Global Developmental Screening (GDS), and the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up (M-CHAT/F) in 1591 toddlers of ages 18–36 months from 35 government-funded clinics in south Israel. The M-CHAT/F performed better than the GDS in detecting toddlers with ASD (sensitivity: 70.0% vs. 50.0%, and specificity: 98.2% vs. 96.6% respectively). Both methods had an equivalent performance in detecting other forms of developmental delays (sensitivity = 63%; and specificity ~ 98%). In addition, remarkable inter-nurse variation was observed in the GDS referral decisions. Thus, employment of the M-CHAT/F in the Israeli health system may improve early detection of ASD among toddlers.

Keywords

Autism spectrum disorder Screening Toddlers M-CHAT 

Notes

Acknowledgments

We would like to thank to all the nurses at the maternal child health centers that participated in this study. This research was supported by Grant No. 527/15 from the Israeli Science Foundation (ISF).

Author Contributions

OK conceived of the study, participated in its design and coordination, performed the statistical analysis, and drafted the manuscript; EJH helped in the interpretation of the data and drafted the manuscript; GM participated in the design and coordination of the study and made all patient diagnoses; ND conceived of the study and participated in the design and coordination of the study; IM conceived of the study, participated in its design and coordination, oversaw the statistical analysis and draft the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10803_2018_3711_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 KB)

References

  1. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-V). Arlington: American Psychiatric Publishing.CrossRefGoogle Scholar
  2. Bin Nun, G., Berlovitz, Y., Shani, M. (2010). The Health Care System in Israel, (2nd ed.), Tel Aviv: Am Oved Publishers Ltd.Google Scholar
  3. Chlebowski, C., Robins, D. L., Barton, M. L., & Fein, D. (2013). Large-scale use of the modified checklist for autism in low-risk toddlers. Pediatrics, 131, e1121–e1127.  https://doi.org/10.1542/peds.2012-1525.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Davidovitch, M., Hemo, B., Manning-Courtney, P., & Fombonne, E. (2013). Prevalence and incidence of autism spectrum disorder in an Israeli population. Journal of Autism and Developmental Disorders, 43, 785–793.  https://doi.org/10.1007/s10803-012-1611-z.CrossRefPubMedGoogle Scholar
  5. Dawson, G., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, e17–e23.  https://doi.org/10.1542/peds.2009-0958.CrossRefPubMedGoogle Scholar
  6. Eaves, L. C., & Ho, H. H. (1996). Brief report: Stability and change in cognitive and behavioral characteristics of autism through childhood. Journal of Autism and Developmental Disorders, 26, 557–569.CrossRefPubMedGoogle Scholar
  7. Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 580–587.  https://doi.org/10.1016/j.jaac.2015.04.005.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Herlihy, L. E., et al. (2014). Standardized screening facilitates timely diagnosis of autism spectrum disorders in a diverse sample of low-risk toddlers. Journal of Developmental and Behavioral Pediatrics: JDBP, 35, 85–92.  https://doi.org/10.1097/dbp.0000000000000014.CrossRefPubMedGoogle Scholar
  9. Israel Ministry of Health. (2016). Guidance for the assessing of developmental assessments for infants and toddlers up to the age of six years.Google Scholar
  10. Johnson, C. P., & Myers, S. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics 120, 1183–1215.  https://doi.org/10.1542/peds.2007-2361.CrossRefPubMedGoogle Scholar
  11. Kamio, Y., Inada, N., Koyama, T., Inokuchi, E., Tsuchiya, K., & Kuroda, M. (2014). Effectiveness of using the Modified Checklist for Autism in toddlers in two-stage screening of autism spectrum disorder at the 18-month health check-up in Japan. Journal of Autism and Developmental Disorders, 44, 194–203.  https://doi.org/10.1007/s10803-013-1864-1.CrossRefPubMedGoogle Scholar
  12. Kleinman, J. M., et al. (2008). The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 827–839.  https://doi.org/10.1007/s10803-007-0450-9.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Levy, S. E., Mandell, D. S., & Schultz, R. T. (2009). Autism. Lancet, 374, 1627–1638.  https://doi.org/10.1016/s0140-6736(09)61376-3.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Magalhães, L. D. C., Cardoso, A. A., Guimarães, M. A. (2015). How can we make our assessment of motor ability relevant cross-culturally. Current Developmental Disorders Reports, 2, 157–164.CrossRefGoogle Scholar
  15. Mahajnah, M., Sharkia, R., Shalabe, H., Terkel-Dawer, R., Akawi, A., & Zelnik, N. (2015). Clinical characteristics of autism spectrum disorder in Israel: Impact of ethnic and social diversities. BioMed Research International.  https://doi.org/10.1155/2015/962093.PubMedPubMedCentralGoogle Scholar
  16. Meiri, G., et al. (2017). Brief report: The Negev Hospital-University-Based (HUB) Autism Database. Journal of Autism and Developmental Disorders, 47, 2918–2926.  https://doi.org/10.1007/s10803-017-3207-0.CrossRefPubMedGoogle Scholar
  17. Mendonca, B., Sargent, B., & Fetters, L. (2016). Cross-cultural validity of standardized motor development screening and assessment tools: A systematic review. Developmental Medicine & Child Neurology, 58, 1213–1222.  https://doi.org/10.1111/dmcn.13263.CrossRefGoogle Scholar
  18. Mohamed, F. E., et al. (2016). Screening of Egyptian toddlers for autism spectrum disorder using an Arabic validated version of M-CHAT; Report of a community-based study (Stage I). European Psychiatry, 34, 43–48.  https://doi.org/10.1016/j.eurpsy.2016.01.2421.CrossRefPubMedGoogle Scholar
  19. Nygren, G., Sandberg, E., Gillstedt, F., Ekeroth, G., Arvidsson, T., & Gillberg, C. (2012). A new screening programme for autism in a general population of Swedish toddlers. Research in Developmental Disabilities, 33, 1200–1210.  https://doi.org/10.1016/j.ridd.2012.02.018.CrossRefPubMedGoogle Scholar
  20. Øien, R. A., et al. (2018). Clinical features of children with autism who passed 18-month screening. Pediatrics.  https://doi.org/10.1542/peds.2017-3596.PubMedGoogle Scholar
  21. Pinto-Martin, J. A., Young, L. M., Mandell, D. S., Poghosyan, L., Giarelli, E., & Levy, S. E. (2008). Screening strategies for autism spectrum disorders in pediatric primary care. Journal of Developmental and Behavioral Pediatrics, 29, 345–350.  https://doi.org/10.1097/DBP.0b013e31818914cf.CrossRefPubMedGoogle Scholar
  22. Raz, R., Weisskopf, M. G., Davidovitch, M., Pinto, O., & Levine, H. (2014). Differences in autism spectrum disorders incidence by sub-populations in Israel 1992–2009: A total population study. Journal of Autism and Developmental Disorders.  https://doi.org/10.1007/s10803-014-2262-z.Google Scholar
  23. Robins, D. L. (2008). Screening for autism spectrum disorders in primary care settings. Autism, 12, 537–556.  https://doi.org/10.1177/1362361308094502.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Robins, D. L., et al. (2016). Universal autism screening for toddlers: Recommendations at odds. Journal of Autism and Developmental Disorders, 46, 1880–1882.  https://doi.org/10.1007/s10803-016-2697-5.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Robins, D. L., Casagrande, K., Barton, M., Chen, C. M., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 133, 37–45.  https://doi.org/10.1542/peds.2013-1813.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144.CrossRefPubMedGoogle Scholar
  27. Samadi, S. A., & McConkey, R. (2015). Screening for autism in Iranian preschoolers: Contrasting M-CHAT and a scale developed in Iran. Journal of Autism and Developmental Disorders, 45, 2908–2916.  https://doi.org/10.1007/s10803-015-2454-1.CrossRefPubMedGoogle Scholar
  28. Siu, A. L., et al. (2016). Screening for autism spectrum disorder in young children: US Preventive Services task force recommendation statement. JAMA, 315, 691–696.  https://doi.org/10.1001/jama.2016.0018.CrossRefPubMedGoogle Scholar
  29. Stenberg, N., et al. (2014). Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatric and Perinatal Epidemiology 28, 255–262.  https://doi.org/10.1111/ppe.12114.CrossRefPubMedPubMedCentralGoogle Scholar
  30. The Central Bureau of Statistics of Israel. (2016). Live birth statistics. Statistical abstract of Israel.Google Scholar
  31. Toh, T. H., Tan, V. W., Lau, P. S., & Kiyu, A. (2017). Accuracy of modified checklist for autism in toddlers (M-CHAT) in detecting autism and other developmental disorders in community clinics. Journal of Autism and Developmental Disorders.  https://doi.org/10.1007/s10803-017-3287-x.Google Scholar
  32. Wiggins, L. D., Piazza, V., & Robins, D. L. (2014). Comparison of a broad-based screen versus disorder-specific screen in detecting young children with an autism spectrum disorder. Autism, 18, 76–84.  https://doi.org/10.1177/1362361312466962.CrossRefPubMedGoogle Scholar
  33. Worley, J. A., Matson, J. L., Mahan, S., Kozlowski, A. M., & Neal, D. (2011). Stability of symptoms of autism spectrum disorders in Toddlers: An examination using the Baby and Infant Screen for Children with aUtIsm Traits-Part 1 (BISCUIT). Developmental Neurorehabilitation, 14, 36–40.  https://doi.org/10.3109/17518423.2010.530638.CrossRefPubMedGoogle Scholar
  34. Zwaigenbaum, L., et al. (2015). Early intervention for children with autism spectrum disorder under 3 years of age: Recommendations for practice and research. Pediatrics, 136(Suppl 1), S60–S81.  https://doi.org/10.1542/peds.2014-3667E.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Health Systems ManagementBen-Gurion University of the NegevBeer ShevaIsrael
  2. 2.Ministry of HealthJerusalemIsrael
  3. 3.Pre-School Psychiatry UnitSoroka University Medical CenterBeer ShevaIsrael
  4. 4.Public Health Department, Faculty of Health SciencesBen-Gurion University of the NegevBeer ShevaIsrael
  5. 5.Zlotowski Center for NeuroscienceBen-Gurion University of the NegevBeer ShevaIsrael

Personalised recommendations