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Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an Urban Metropolitan Sample of Young Children in Turkey

  • Ozgur OnerEmail author
  • Kerim M. Munir
Original Paper
  • 40 Downloads

Abstract

The study assessed the feasibility of using a Turkish-version of the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R/F) as a screening tool for an urban low risk population of young children. M-CHAT-R/F was completed for 6712 children between ages 16 and 36 months living in Istanbul, Turkey. Autism Diagnostic Observation Schedule-2 was served as the main measure for diagnosis. M-CHAT-R/F screen was positive for 9.8% of children. At follow up interview, 39.7% of initial screen-positive children met criteria for ASD. The study identified 57 (1 in 117) children with ASD (0.8%; 95% CI 0.063–1.05%). M-CHAT-R/F performed comparably in Turkey as in United States. Implications of the study for future universal screening for autism in Turkey is also discussed.

Keywords

Autism MCHAT-R/F Urban population Screening Diagnosis Turkey 

Notes

Acknowledgments

Drs. Ozgur Oner and Kerim Munir were supported, in part, by Fogarty International Center/NIMH Grant No. (D43TW009680) at Boston Children’s Hospital. We also like to thank Betül Yıldırım, Betul Olgun, Cansu Tacı, Fulin Kurtkaya, Betul Selcen Ozer, Ozgul Gurel, Selcen Keskin Oner, psychologists, physicians, nurses, and families that took part in the study.

Author Contributions

Dr. Oner designed the study, collected and analyzed data, drafted the manuscript and revised it. Dr. Munir contributed to conceptualization, data analysis, discussion of findings, revision of the first draft and other versions of the manuscript.

Funding

This study was funded by İstanbul Kalkinma Ajansi (ISTKA).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Al-Qabandi, M., Gorter, J. W., & Rosenbaum, P. (2011). Early autism detection: Are we ready for routine screening? Pediatrics, 128(1), e211–e217.CrossRefPubMedGoogle Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Association.CrossRefGoogle Scholar
  3. Anlar, B., Bayoglu, B. U., & Yalaz, K. (2009). Denver II Screening Test: Standardization and Adaptation for Turkish Children.Google Scholar
  4. Baduel, S., Guillon, Q., Afzali, M. H., Foudon, N., Kruck, J., & Rogé, B. (2017). The French version of the modified-checklist for autism in toddlers (M-CHAT): A validation study on a French sample of 24 month-old children. Journal of Autism and Developmental Disorders, 47(2), 297–304.CrossRefPubMedGoogle Scholar
  5. Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of Autism spectrum disorder among children aged 8 years - Autism and developmental disabilities monitoring network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1–23.CrossRefPubMedCentralGoogle Scholar
  6. Brennan, L., Fein, D., Como, A., Rathwell, I. C., & Chen, C. M. (2016). Use of the modified checklist for autism, revised with follow up-Albanian to screen for ASD in Albania. Journal of Autism and Developmental Disorders, 46(11), 3392–3407.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Christensen, D. L., Bilder, D. A., Zahorodny, W., et al. (2016). Prevalence and characteristics of autism spectrum disorder among 4-year-old children in the Autism and Developmental Disabilities Monitoring Network. Journal of Developmental and Behavioral Pediatrics, 37, 1–8.CrossRefPubMedGoogle Scholar
  8. Christensen, D. L., Braun, K. V. N., Baio, J., Bilder, D., Charles, J., Constantino, J. N., et al. (2012). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 Sites. United States. MMWR Surveillance Summaries (2018), 65(13), 1–23.Google Scholar
  9. Christensen, D. L., Maenner, M. J., Bilder, D. A., Constantino, J. N., et al. (2019). Prevalence and characteristics of autism spectrum disorder among children aged 4-years- early autism and developmental disabilities monitoring network, seven sites, United States, 2010, 2012 and 2014. MMWR Surveillance Summaries, 68, 1–19.CrossRefPubMedCentralGoogle Scholar
  10. Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, & Medical Home Initiatives for Children With Special Needs Project Advisory Committee. (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118(1), 405–420.CrossRefGoogle Scholar
  11. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The early start Denver model. Pediatrics, 125(1), e17–e23.CrossRefPubMedGoogle Scholar
  12. Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcín, C., et al. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Fenikilé, T. S., Ellerbeck, K., Filippi, M. K., & Daley, C. M. (2015). Barriers to autism screening in family medicine practice: A qualitative study. Primary Health Care Research and Development, 16(4), 356–366.CrossRefPubMedGoogle Scholar
  14. Frankenburg, W. K., & Dodds, J. B. (1990). Denver II screening manual. Denver: Denver Developmental Materials, Inc.Google Scholar
  15. García-Primo, P., Hellendoorn, A., Charman, T., Roeyers, H., Dereu, M., Roge, B., et al. (2014). Screening for autism spectrum disorders: State of the art in Europe. European Child and Adolescent Psychiatry, 23(11), 1005–1021.CrossRefPubMedGoogle Scholar
  16. Guo, C., Luo, M., Wang, X., Huang, S., Meng, Z., Shao, J., et al. (2019). Reliability and validity of the Chinese version of modified checklist for autism in toddlers, revised, with follow-up (M-CHAT-R/F). Journal of Autism and Developmental Disorders, 49(1), 185–196.CrossRefPubMedGoogle Scholar
  17. Gupta, V. B., Hyman, S. L., Johnson, C. P., Bryant, J., Byers, B., Kallen, R., et al. (2007). Identifying children with autism early? Pediatrics, 119(1), 152–153.CrossRefPubMedGoogle Scholar
  18. Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114(1), 23–41.CrossRefPubMedGoogle Scholar
  19. Johnson, C. P., & Myers, S. M. (2007). American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215.CrossRefPubMedGoogle Scholar
  20. Jöreskog, K. G. (1971). Statistical analysis of sets of congeneric tests. Psychometrika, 36, 109–133.CrossRefGoogle Scholar
  21. Kamio, Y., Haraguchi, H., Stickley, A., Ogino, K., Ishitobi, M., & Takahashi, H. (2015). Brief report: Best discriminators for identifying children with autism spectrum disorder at an 18-Month Health Check-Up in Japan. Journal of Autism and Developmental Disorders, 45(12), 4147–4153.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Khowaja, M. K., Hazzard, A. P., & Robins, D. L. (2015). Sociodemographic barriers to early detection of autism: Screening and evaluation using the M-CHAT, M-CHAT-R, and follow-up. Journal of Autism and Developmental Disorders, 45(6), 1797–1808.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Kleinman, J. M., Ventola, P. E., Pandey, J., Verbalis, A. D., Barton, M., Hodgson, S., et al. (2008). Diagnostic stability in very young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 606–615.CrossRefPubMedGoogle Scholar
  24. Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012a). Autism diagnostic observation schedule, second edition (ADOS-2) (Part I): Modules 1-4 torrance. CA: Western Psychological Services.Google Scholar
  25. Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012b). Autism diagnostic observation schedule, second edition (ADOS-2) (Part II): Toddler module torrance. CA: Western Psychological Services.Google Scholar
  26. McDonald, R. P. (1999). Test theory: A unified treatment. Mahwah: Lawrence Erlbaum Associates Inc.Google Scholar
  27. Munir, K. (2016). Co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Current Opinion in Psychiatry, 29(2), 95–102.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Munir, K. M., Lavelle, T. A., Helm, D. T., Thompson, D., Presstt, J., & Azeem, M. W. (2016). Autism: Global framework for action. Doha: World Innovation Summit in Health.Google Scholar
  29. National Collaborating Centre for Women’s and Children’s Health (UK). (2011). Autism: Recognition, referral and diagnosis of children and young people on the autism spectrum. London: RCOG Press.Google Scholar
  30. Reich, S. (2005). What do mothers know? Maternal knowledge of child development. Infant Mental Health Journal, 26(2), 143–156.CrossRefPubMedGoogle Scholar
  31. Robins, D. L., Casagrande, K., Barton, M. L., Chen, C., Dumont- Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers-revised with follow-up (MCHAT- R/F). Pediatrics, 133(1), 37–45.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Robins, D. L., Fein, D., & Barton, M. (2009). The modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F).Google Scholar
  33. 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(2), 131–144.CrossRefPubMedGoogle Scholar
  34. Rosenthal, R., & Jacobson, L. (1992). Pygmalion in the classroom: Teacher expectation and pupils’ intellectual development. Bancyfelin: Crown House Pub.Google Scholar
  35. Seung, H., Ji, J., Kim, S. J., Sung, I., Youn, Y. A., Hong, G., et al. (2015). Examination of the Korean modified checklist of autism in toddlers: Item response theory. Journal of Autism and Developmental Disorders, 45(9), 2744–2757.CrossRefPubMedGoogle Scholar
  36. Silverstein, M., & Radesky, J. (2016). Embrace the complexity: The US Preventive Services Task Force recommendation on screening for autism spectrum disorder. JAMA, 315(7), 661–662.CrossRefPubMedGoogle Scholar
  37. Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., et al. (2016). Screening for autism spectrum disorder in young children. Journal of American Medical Association, 315(7), 691.CrossRefGoogle Scholar
  38. Srisinghasongkram, P., Pruksananonda, C., & Chonchaiya, W. (2016). Two-step screening of the modified checklist for autism in toddlers in Thai children with language delay and typically developing children. Journal of Autism and Developmental Disorders, 46(10), 3317–3329.CrossRefPubMedGoogle Scholar
  39. Stenberg, N., Bresnahan, M., Gunnes, N., Hirtz, D., Hornig, M., Lie, K. K., et al. (2014). Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatric and Perinatal Epidemiology, 28(3), 255–262.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Stone, L. S., Janssens, J. M. A. M., Vermulst, A. A., Van Der Maten, M., Engels, R. C. M. E., & Otten, R. (2015). The Strengths and Difficulties Questionnaire: Psychometric properties of the parents and tacher version in children aged 4-7. BMC Psychol, 3, 4.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Thompson, T. (2013). Autism research and services for young children: History, progress and challenges. Journal of Applied Research in Intellectual Disabilities, 26(2), 81–107.CrossRefPubMedGoogle Scholar
  42. Tsai, J. M., Lu, L., Jeng, S. F., Cheong, P. L., Gau, S. S., Huang, Y. H., et al. (2019). Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers. Research in Developmental Disabilities, 85, 205–216.CrossRefPubMedGoogle Scholar
  43. Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., et al. (2015). Early Screening of Autism Spectrum Disorder: Recommendations for practice and research. Pediatrics, 136(Suppl 1), 41–59.CrossRefGoogle Scholar
  44. Zwaigenbaum, L., Bryson, S., & Garon, N. (2013). Early identification of autism spectrum disorders. Behavioural Brain Research, 251, 133–146.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Child PsychiatryBahcesehir University School of MedicineIstanbulTurkey
  2. 2.Boston Children’s HospitalHarvard Medical SchoolBostonUSA

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