MODIFIED CHECK LIST AUTISM IN TODDLERS: SPANISH VERSION AND VALIDATION (MCHAT/ES)

Background: Although retrospective reports suggest that most parents identify ASD symptoms before 18 months of age and that a diagnosis of autism can be reliably made between 2 and 3 years of age, ASD diagnoses are often delayed until mid-childhood. The M-CHAT (Robins et. Al, 2001), a 23-item parent-report checklist has been designed as a screening tool to detect high risk ASD children but there is not enough information about the feasibility and validity of this tool in a population-based study, Objectives: To analyze the validity of the Spanish version of the MCHAT for early detection of ASD in a Spanish population. Methods: The MCHAT was translated into Spanish and a cross-cultural adaptation was performed (MCHAT/ES). A population-based ASD screening programme using MCHAT/ES version was established in three Spanish regions. Parents of 18 months and/or 24 months aged children were asked to fill in this questionnaire at the outpatient health services (compulsory vaccination programme and well-child check-up programme respectively) (SP). For validation purposes, children referred (CR) for early intervention services with either ASD diagnosis or non-ASD developmental disorder were included to enrich the sample. The original MCHAT criteria and a refining procedure for the phone call were adopted after agreement with the MCHAT authors, Results: A total of 5,188 children were included. 29 ASD children, (10 from SP and the other 9 from CR), 71 non ASD developmental disorders (28 from SP and 43 from CR). Both sensitivity and specificity showed high values only if both questionnaire and a systematic phone call were used. Conclusions: The MCHAT/ES shows promise as a screening tool for developmental disorders in an unselected population. However, the cut-off point when only the questionnaire is used should be raised This work is an important contribution to ongoing research into identification of ASD at a young age.