International Meeting for Autism Research: Population Screening for ASD: a Comparison of M-CHAT and ESAT

Population Screening for ASD: a Comparison of M-CHAT and ESAT

Friday, May 21, 2010: 4:25 PM
Grand Ballroom F Level 5 (Philadelphia Marriott Downtown)
3:45 PM
J. Buitelaar , Karakter Child and Adolescent Psychiatry University Center Nijmegen, Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands
Background: ESAT and M-CHAT are instruments designed for the screening of ASD in very young children in the general population.

Objectives: To describe the response to the ESAT and M-CHAT and explore overlap and difference in screen-positive children identified with ESAT and M-CHAT. Further, to examine external validity of ESAT and M-CHAT, by exploring relationships with proxy-measures of clinical caseness.

Methods: The data were collected in the context of the Autism Birth Cohort Study, an ongoing, prospective birth cohort study in Norway. Mothers of 12,948 18 months old children completed a questionnaire which included items from the ESAT, M-CHAT and other items about their child’s social and emotional development and behavior.

Results: The percentages screen-positive children on the ESAT (0.5%) and M-CHAT (5.4%) differed significantly from each other (p<.01). Among all children, 94% was screen-negative on both questionnaires, 0.33 % was screen-positive on both, 0.2% was only screen-positive on the ESAT, and 5% was only screen-positive on the M-CHAT. Exploration of the ESAT and M-CHAT in relation to proxy-measures revealed the highest percentage of clinical and developmental concerns for children who were screen-positive on both questionnaires. ESAT only screen-positive children scored relatively high on items of behavioral and temperamental problems. For the M-CHAT only screen positive group there were more concerns about motor development.

Conclusions: Results of this study demonstrated that the ESAT and M-CHAT have different profiles in terms of the number and kind of children which are screen positive. Based on the relationship with proxy-measures, the ESAT tends to pick up children with more serious language and behavioral problems whereas the M-CHAT picks up children with more mild and general developmental delays. In addition to presenting comparative data of the ESAT and M-CHAT, issues related to the age at screening and the relationship to caregiver follow-up on results will also be discussed.