PARS-Short Version Screening System for Recognizing ASD Children's Early Support Needs on the Public Health Checkup Service for 3yeas Old Children In Japan

Background: Behavioral abnormalities in children with Asperger’s disorder can be recognized before 2 years of age. Deficits in social responsiveness, communication,and play are present in those as young as age 6-12 months. At 36 months old, clinical signs become more overtas ever, and parents begin to concern about diagnostic possibility. And then, parents get ready to participate their child to group activity  such as kindergarten or nursery school. Prior to enter kindergarten and so on, to have awareness of child’s developmental character influencing adaptation or maladaptation was necessary. To recognize support needs of each child accurately at this point, we introduced screening programs for Autism Spectrum Disorders(ASD)  including Higher Functionig-ASD among the community population of 36 month old toddlers, capitalizing on existing regular health checkups for 36-month-old children, which started in 1977 in Japan. Under Maternal and Child Health Act, local government were obligated to offer this checkup service to all mothers twice when child reached 18 month and 3 years of age.

Objectives: The purpose of this study was to examine the prevalence of screened positive as ASD comparing to previous studies, and to clarify the needs of screened children in Japan.

Methods: Participants consisted of 371 parents and their children who take the 3-yerars-old checkup by public health service from July to November in a city X, Aichi Prefecture, located in central Japan.Measure: Parvasive Developmental Disorders Autism Society Japan Rating Scale (PARS: Tani et al., 2009, 2010) short-version was used. This scale composed of 12items, which applay core domains of autism, socialisation, communication, and restricted receptive patterns of behavior. Public health nurses were trained to rate PARS short-version  and hearing all mothers participating 3-years-oid health checkup service. Community sample was divided to positive or negative group of screening and compared to ASD children (N=31) and normally developing children (N=131).

Results: By One-Way ANOVA and multiple comparison analyses, the score of community sample composed of all participants (Mean=2.04 SD=2.80) was significantly higher than normal developing children (Mean=0.80 SD=1.73), but significantly lower than that of PDD children (Mean=10.20 SD=4.85) (F>216.22). Rate of positive children in our screening was 18.1%. The score of positive children was significantly lower than that of PDD children (t>8.56, p<.01). No significant difference was seen between negative-children from community sample and normal developing children.

Conclusions: The prevalence of screened (18.1%) was higher than ASD’s or PDD morbidity known widely. This result was valid to minimize false negative in screening. It was considered that positive children screened by our PARS-SV system in community sample was composed of variety state in relation to developmental risk, in contrast PDD children already diagnosed. PARS-SV screening system for public health checkup service for 3 years equipped adequate validity about screening rate and comparison with clinical sample. Scores and contents about individuals were expected to share with public facilities in same city as support needs information.