Mawle E, Griffiths P. Screening for autism in pre-school children in primary care: Systematic review of English Language tools.
Int J Nurs Stud 2006;
43:623-36. [PMID:
16387303 DOI:
10.1016/j.ijnurstu.2005.11.011]
[Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 10/10/2005] [Accepted: 11/15/2005] [Indexed: 11/16/2022]
Abstract
OBJECTIVES
To review the accuracy of brief screening tools for autism in pre-school children.
DESIGN
Systematic review of diagnostic accuracy studies.
DATA SOURCES
Medline, Embase, Cinahl and Psychlit plus references of identified papers and contact with authors.
SUBJECTS
Children and infants aged 5 years or less without a prior diagnosis of autism or pervasive development delay.
INTERVENTIONS
Tools/checklists appropriate for use in screening for autism in primary care settings.
OUTCOME MEASURES
Sensitivity, specificity, positive and negative predictive value of screening tools and likelihood ratios relative to a diagnostic assessment made using either DSM-III/IV or ICD 10 diagnosis.
RESULTS
Three studies considering two tools were identified. The CHecklist for Autism in Toddlers (CHAT) was tested on an appropriate population sample with moderate long-term follow-up but demonstrated poor sensitivity and positive predictive value. Weaker evidence suggested that the Modified CHecklist for Autism in Toddlers (M-CHAT) had high sensitivity but follow-up was of shorter term and less comprehensive.
CONCLUSIONS
The CHAT demonstrated a level of sensitivity unlikely to be useful for population screening purposes, however, its high specificity suggests it has utility in secondary screening. The M-CHAT is a parent only report and might be more sensitive, and therefore appropriate for population screening. However, full conclusions regarding its accuracy cannot be drawn until follow-up data has been collected.
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