Modified checklist with follow-up valid for autism in toddlers

(HealthDay)—The Modified Checklist for Autism in Toddlers (M-CHAT) with Follow-up Interview (M-CHAT/F), which can be administered by minimally trained primary care physicians (PCPs) is valid and reliable, according to a study published online Aug. 19 in Pediatrics.

Raymond Sturner, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the feasibility, validity, and reliability of the M-CHAT/F by PCPs with online prompts at the time of a positive M-CHAT screen. A total of 197 M-CHAT/Fs triggered by positive M-CHAT screens were completed by 47 PCPs from 22 clinics via the same secure web-based platform that parents used to complete M-CHATs before an 18- or 24-month well-child visit. A second M-CHAT/F was administered by trained research assistants (RA). As criterion measures, the Autism Diagnostic Observation Schedule, Second Edition, and the Mullen Scales of Early Learning were administered; measures of agreement were compared between PCPs and RAs.

The researchers observed 86.6 percent agreement between PCPs and RAs (Cohen's κ, 0.72). Significant equivalence was seen for all measures in comparison of sensitivity, specificity, positive predictive value (PPV), and overall accuracy for M-CHAT/F between PCPs and RAs. There was significant improvement in PPV for use of the MCAT/F by PCPs versus M-CHAT alone.

"Minimally trained PCPs can administer the M-CHAT/F reliably and efficiently during regular well-child visits, increasing PPV without compromising detection," the authors write.

Several authors disclosed financial ties to Total Child Health.