International Meeting for Autism Research (May 7 - 9, 2009): The Passage Rate on Each Item of the M-CHAT for Children with ASD: The Cultural Differences Between Japan and USA

Saturday, May 9, 2009

Northwest Hall (Chicago Hilton)

10:00 AM

N. Inada , Child and Adolescent Mental Health, National Center of Neurology and Psychiatry, Japan, National Institute of Mental Health, Tokyo 187-8553, Japan

T. Koyama , Child and Adolescent Mental Health, National Center of Neurology and Psychiatry, Japan, National Institute of Mental Health, Tokyo, Japan

Y. Kamio , Child and Adolescent Mental Health, National Center of Neurology and Psychiatry, Japan, National Institute of Mental Health, Tokyo 187-8553, Japan

Background: The Modified Checklist for Autism in Toddlers (M-CHAT) is a yes/no 23-item parent-report developmental screener designed to detect Autism Spectrum Disorders (ASD). Its Japanese version have been developed and validated; however, to introduce the M-CHAT in Japan further, we need to consider how Japanese childrearing culture influences on parent-report.

Objectives: To investigate how much the passage rate on each item of the M-CHAT in children with/without ASD differs between Japan and USA.

Methods: The participants were 2063 children with non-ASD and 27 children with ASD who received the M-CHAT at 18-month health check-up in Japan. Children with ASD were diagnosed at the age of 2 using DSM-IV-TR and Childhood Autism Rating Scale-Tokyo Version (CARS-TV). We calculated the passage rate on each item of the M-CHAT for children with ASD/non-ASD and compared with those in the USA counterparts (Robins et al, 2001).

Results: For children with non-ASD, the passage rates on each item were very similar bothb in Japan and USA. For children with ASD, however, the Japanese children passed 20% higher compared to USA children on 14 items. Especially, 5 items out of the 14 items showed 40% higher: “interest in other children” (Japan vs. USA, 88.9% vs. 41.0%), “response to name” (85.2% vs. 35.9%), “pointing-following” (81.5% vs. 25.6%), “attract parents’ attention” (77.8% vs. 23.1%), and “concern with hearing” (100.0% vs. 46.2%). On the other hand, the Japanese children with ASD passed less on the item “social reference” (51.9% vs. 82.1%).

Conclusions: It might be difficult for Japanese parents to give definite negative answers to their children’s mild or subthreshold abnormal behaviors. To screen Japanese children with ASD using the M-CHAT effectively, we may need to apply grading answers instead of yes/no one, like Wong et al (2004) did in Chinese version.

Sponsor: RISTEX (Research Institute of Science and Technology for Society)

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