A score in the high-risk range warrants a referral for further evaluation for possible autism. For a child determined to be at medium risk, M-CHAT R/F includes a follow-up questionnaire used soon after the original evaluation to obtain additional information needed to more definitively classify the child as either high risk or low risk.Based on the M-CHAT-R/F classifications, the researchers found that a smaller proportion of children received a medium- or high-risk assessment than with earlier versions of the checklist. However, more total cases of autism were detected with the revised checklist than with earlier versions 67 cases per 10,000 screened vs 45 cases per 10,000 screened.
Of the more than 16,000 children evaluated with the screening tool, 93 percent of the children screened were considered low-risk, 6 percent were in the medium-risk range and 1 percent were considered high-risk.Of all the children who determined by the test to be at risk after the M-CHAT-R/F follow-up, 95 percent were eventually found to have some form of developmental delay, including more than 47 percent with autism spectrum disorder.First author Diana L. Robins, Ph.D., of Georgia State University, in Atlanta, conducted the research with GSU colleague Karís Casagrande, and Marianne Barton, Ph.D., Chi-Ming Chen, Ph.D., Thyde Dumont-Mathieu, M.D., M.P.H., and Deborah Fein, Ph.D., all of the University of Connecticut in Storrs. Dr. Fein was the study's senior author.
The findings appear in Pediatrics.The researchers updated an earlier version of the autism screening tool, adding examples, rephrasing some questions and dropping others that previously did not elicit strong responses. Using the revised tool, the researchers worked with health care providers to screen more than 15,000 toddlers considered at low risk for autism."Earlier tools cast a wider net, but these refinements will allow health care providers to focus energy where it is needed most and will reduce the number of families who go through additional testing but which ultimately do not need treatment interventions," said Dr. Fein.
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