Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) Validation in Portugal - Preliminary Findings
Autism Spectrum Disorder (ASD) screening has been recommended as a way to start early intervention as soon as possible in order to improve outcomes. However, screening is not yet a common procedure in Portugal. In order to promote ASD screening, using a tool validated in other countries, an M-CHAT-R study has been started with the collaboration of Georgia State University. Preliminary findings are presented.
The main goal of this study is to start the validation of the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) in Portugal as a screening tool for low-risk toddlers.
Toddlers are recruited from two sources: childcare centers and pediatric check-ups. To date, 485 toddlers between 16 and 30 months (m=23.01, SD=3.92) were screened with M-CHAT-R. Parents of toddlers at risk on M-CHAT-R completed the M-CHAT-R Follow-up as an interview, and those who continued to show risk were evaluated using Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview Revised (ADI-R) and Griffiths Mental Development Scale.
From the 391 screened in daycare, 34 were positive (8.7%). After the Follow-up, six continued to screen positive and three were diagnosed with an ASD, two were typically developing and one had a developmental delay. From the 94 toddlers screened in pediatricians settings, eight were positive (8.5%), after the Follow-up two continued to screen positive; neither one was diagnosed with ASD (one had a developmental delay).
Across the two groups, the M-CHAT-R performed similarly (8.7 vs 8.5% screened positive initially), suggesting that it is important to screen in multiple settings until screening is thoroughly incorporated into well-child care. The M-CHAT-R appears to be performing similarly to other countries’ studies, such as in the US and Spain. Professionals from daycares seem more willing to screen than pediatricians during check-ups. Portugal requires more information and awareness about ASD screening to help children at risk for ASD get identified and into early intervention as young as possible.