A Pilot Project for Using the Screening Tool for Autism in Toddlers and Young Children As Part of An Intake Process

Background: The waiting list for diagnostic services related to autism spectrum disorders (ASD) is often very long. Screening measures are one means of more efficiently identifying children who are in need of comprehensive evaluations for an ASD. However, Level 1 screening tools have high false positive rates. The Screening Tool for Autism in Toddlers and Young Children (STAT) is a second level screening tool that provides direct assessment of children as opposed to parent report.  The STAT is designed to be administered by service providers with experience in working with young children and with ASDs thus relying upon clinical experience and expertise but does not require administration by professionals with advance degrees.

Objectives: The objectives in this study were to examine (1) the rates of a positive STAT screen of children referred for a developmental evaluation or an ASD-specific evaluation and (2) among children identified as at risk by the STAT, the rate of agreement when compared to the clinical diagnosis made as part of a comprehensive ASD evaluation.

Methods:  The STAT was administered by social workers, nurse practitioners, and Developmental-Behavioral Pediatrics fellows as part of the intake procedures for an autism clinic and as a screening tool in an early childhood and NICU follow-up clinic. Children who screened as at risk on the STAT subsequently were administered a comprehensive ASD evaluation by Psychologists and Developmental-Behavioral Pediatricians specializing in ASDs.

Results: Rates of children referred for concerns of ASD and identified as at risk on the STAT will be determined.  This will be compared to the rates of children referred for a developmental evaluation without concerns of an ASD but who were subsequently identified as at risk on the STAT.  Among those children who then completed a comprehensive ASD evaluation, the results of the STAT will be compared to the results of the ADOS and the clinical diagnosis made as part of the evaluation.

 Conclusions: The impact of the STAT on the process of directing children to the most appropriate evaluation will be discussed. The use of the STAT as an advanced screening tool among children referred for developmental evaluations but not specifically ASD will be discussed in the context of a tool for earlier identification. The practicality of use of the STAT by less experienced individuals will also be discussed.