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Feasibility and Reliability of an ASD Systematic Screening Program in France

Friday, 3 May 2013: 14:45
Meeting Room 3 (Kursaal Centre)
S. Baduel, Q. Guillon and B. Roge, Laboratoire Octogone/CERPP, University of Toulouse, Toulouse, France
Background: The American Academy of Pediatrics recommends that each child should be screened for an ASD risk from 18 months of age. In France, the Haute Autorité de Santé(2005) gives the same recommendation. Therefore some practical considerations like professional training, validation of screening tools, and creating coordinated professional networks must be considered in order to reach this goal. However lack of sufficient materials in these domains lead us to conduct the present research.

Objectives: To determine the feasibility and the reliability of implementing an ASD systematic screening program for 24 months old children in Midi-Pyrénées(south-west region of France).

Methods: Child primary care professionals (pediatricians and child care workers) were first trained to detect signs of ASD in young children. In a second step, these professionals were asked to propose every parent to be enrolled in the program. Parents filled out the M-CHAT (Modified- Checklist for Autism in Toddlers) and professionals administrated the five observation items of the CHAT (Checklist for Autism in Toddlers) at 24 months of age. The five observation items of the CHAT were administrated at 30 and 36 months of age. Children who failed at least one key item at 24 months were evaluated with the ADOS module 1, the PEP-R, the Griffiths Mental Development Scales and the VABS. A follow-up assessment was conducted at 36 month-olds to establish the final diagnosis.

Results: Child primary care professionals screened 1160 children at 24 months; 33 children failed the screening and were clinically and developmentally evaluated with the above-mentioned tests. Among them, 16 received a final diagnosis of ASD. Sensibility, specificity, positive predictive value, negative predicative value was calculated for the M-CHAT (56%; 99%; 47%; 99%), the CHAT (93%; 99%; 65%; 99%) and combination of both tools (93%; 98%; 51%; 99%).

Conclusions: This screening program increased child primary care professionals’ awareness of early signs of ASD. The CHAT and the M-CHAT appeared to be effective as to the screening of developmental disorders, such as ASD. Moreover, children screened at risk for ASD benefited from early diagnosis and early intervention. Overall, this study enabled us to create a network of screening, diagnosis and intervention professionals.

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