Objective To evaluate the efficacy of screening of autism spectrum disorders (ASDs) by using the Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) combined with the Ages and Stages Questionnaire-Third Edition(ASQ-3),in order to provide scientific basis for early identification of autism. Methods Totally 291 toddlers aged 16~30 months who have conducted routine health care in six hospitals and with positive screening Results of M-CHAT-R were enrolled in this study from August 2016 to March 2017,and the parents were invited to fill out ASQ-3 to assess the children's development of communication (C),gross motor (GM),,fine motor (FM),problem solving (SP),and personal-social (PS).Meanwhile,these children were referred to specialists for diagnostic evaluations according to DSM-5.The positive predictive value (PPV) for ASD of M-CHAT-R/F alone and that of M-CHAT-R/F combined with ASQ-3 were compared. Results A total of 53 of the 291 toddlers were diagnosed with ASD.The PPV for ASD of M-CHAT-R was 0.18.The communication domain of ASQ-3 had the highest suspicious developmental delay rate in both M-CHAT-R screening positive group and ASD group,followed by PS domain.The PPV for ASD detection could be increased to 0.43 using communication and PS domains as predictors on the basis of M-CHAT-R.Without follow-up interview,ASQ-3 could greatly improve the PPV of M-CHAT-R (0.43 vs.0.18,P<0.001). Conclusions M-CHAT-R combined with ASQ-3 could improve the screening effcacy of toddlerhood ASD.It is recommended to conduct assessment by ASQ-3 for toddlers with positive screening Results of M-CHAT-R.
Key words
screening /
autism spectrum disorder /
Modified Checklist for Autism in Toddlers-Revised with Follow Up /
Ages and Stages Questionnaire /
positive predictive value
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