Autism Diagnostic Team Training Screening Louann Rinner, MSEd, OTR/L

Learn the Signs. Act Early. •  Centers for Disease Control and Prevention

http://www.cdc.gov/ncbddd/actearly

Program Purpose To improve early identification of autism and other developmental disabilities so children and their families can get the services and support they need o Health Education o Act Early Initiative o Research and Evaluation

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Screening Tools Selection Criteria •  Historical/Statistical Significance –  Validated –  Use developmental milestones –  Meet DSM-IV criteria (ASD specific) –  Established tool –  Peer reviewed –  Nationally recognized First Signs, Inc.

Screening Tools Selection Criteria •  Ease of Use by Physician/Provider –  Can be administered all well visits, 12-36 mo. –  Less than 10 minutes to complete –  Easy/fast tabulation (under 5 minutes) –  Parent report –  Easy to store and maintain –  Easy to explain to family First Signs, Inc.

Screening Tools Selection Criteria •  Easy for Parent/Caregiver –  Fill out in 10 minutes or less –  Multiple choice –  Fourth to sixth grade reading level –  Available in other languages –  Alternative administration methods –  Can be mailed –  Available at minimal expense –  Low cost to maintain First Signs, Inc.

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Developmental and Behavioral Screening Tools •  Ages and Stages Questionnaire – Third Edition (ASQ-3) by Jane Squires, Ph.D., Elizabeth Twombly, M.S., Diane Bricker, Ph.D. & LaWanda Potter, M.S. (for children 4-60 months) •  Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) by Jane Squires, Ph.D. & Diane Bricker, Ph.D. & Elizabeth Twombly, M.S. (for children 6-60 months) •  CSBS DP Infant-Toddler Checklist by Amy Wetherby, Ph.D. & Barry Prizant, Ph.D. (for children 6-24 months) –  http://firstwords.fsu.edu/pdf/checklist.pdf

Developmental and Behavioral Screening Tools •  Parents Evaluation of Developmental Status (PEDS) by Frances Page Glascoe, Ph.D. (for children 0-8 years)

ASD Specific Screening Tools Birth to 36 Months •  ( OLD) Modified Checklist for Autism in Toddlers (MCHAT) by Diana Robins, M.A., Deborah Fein, Ph.D., et al. (validated for children 16-30 months) •  (2009) Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) by Diana Robins, Deborah Fein, & Marianne Barton (Joaquin Fuentes – interview flowchart) (validated for children 16-30 months) •  Screening Tool for Autism in Toddlers & Young Children (STAT) (administered between 24 and 36 months)

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ASD Screening Tools Three Years to Adult •  Autism Spectrum Screening Questionnaire (ASSQ) by Stephen Ehlers, Ph.D., Christopher Gillberg, Ph.D., Lorna Wing, Ph.D. (Published in 1999 in the Journal of Autism and Developmental Disorders, 29,129-141) (for children 7-16) •  Social Communication Questionnaire (SCQ) by Catherine Lord, Ph.D., Sir Michael Rutter, Ph.D., et al. (for children 4 and older) –  Current, Lifetime

•  Australian Scale for Asperger Syndrome (ASAS) by Michelle Garnett, M. Clinical Psychology, Anthony Attwood, Ph.D. (for children 5 and older)

ASD Screening Tools Three Years to Adult •  Autism Spectrum Screening Questionnaire (ASSQ) byFiona Scott, Simon Baron-Cohen, Patrick Bolton, and Carol Brayne (for children 4–11)

M-CHAT Overview •  MCHAT follow-up interview – http://www2.gsu.edu/~psydlr – www.mchatscreen.com

https://www.m-chat.org/

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MCHAT •  Parent Report •  23 yes/no items –  Minimum 2 of 6 “Critical” items ► referral to specialists (at risk for autism) –  Minimum of ANY 3 of 23 items ► referral to specialists

•  Follow-up questions only for at-risk responses •  May bypass interview if total score > 10

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M-CHAT-R/F •  Modified Checklist for Autism in Toddlers, Revised with Follow-up

•  Robins, D.L., Casagrande, K., Barton, M., Chen, C.A., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F). Pediatrics, (133)37. doi: 10.1542/peds.2013-1813

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M-CHAT-R/F •  2-stage screener •  20 yes/no questions (parent response) 1. Three items dropped (Peekaboo, toys, wandering 2. Items reorganized 3. Emphasis items in first 10 4. Simplified language 5. Contextual examples

M-CHAT-R/F Scoring Algorithm •  LOW-RISK: Total Score 0-2 –  < 24mo., screen again at 2 yrs.

•  MEDIUM-RISK: Total Score 3-7 –  Interview, rescore, if 2 or greater, refer for evaluation

•  HIGH-RISK: Total Score is 8-20 –  Skip interview and refer immediately for diagnostic evaluation AND Early Intervention

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Final Screening Notes

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