The importance of early identification of children at risk of being diagnosed with autism is critical for better intervention outcomes. Kim et al. (2002) examined validity of Korean Checklist of Autism in Toddlers (CHAT, Baron-Cohen, 1992) in 16-20 month old children. The Modified-Checklist of Autism in Toddlers (M-CHAT, Robbins et al., 2001) is an expansion of the CHAT in the number of items (9 to 23 items) and age range (18 months to 16-30 months). The M-CHAT has demonstrated utility in screening children for autism. However, no study has yet validated whether the Korean version of the M-CHAT identifies Korean children at risk as sensitively as the English M-CHAT.
Objectives:
1) To evaluate the validity of the Korean M-CHAT in unselected children by using the English screening criteria (either fail two or more on the six critical items, or three or more on the 23 total items), 2) to examine the Korean translation by examining response distribution on each item, 3) to examine positive predictive value (number who screened positive/total children screened) and negative predictive value (number who screened negative/total children screened), and 4) to examine if the Korean M-CHAT can be used for children between 16 and 36 months (instead of 16-30 months).
Methods:
Parents of 16-36 month old children were recruited at a Public Health Center where parents brought children for vaccinations, and public/private daycare centers across South Korea. A two page printed copy in Korean (California State University, Fullerton, IRB approved informed consent form and the M-CHAT) was presented to parents.
Results:
The results of this submission are based on a subset of data collected in Chungcheongnam-Do (n=219). Seven hundred respondents have completed the Korean M-CHAT since July 2012; data collection will continue with a goal of recruiting 1000 participants. The scoring is well underway using the automatic scoring program that Diana Robins made available. Data coding and analysis will be completed by March, 2013.
Results of current data were 163/219 (74 %) screened negative and 56/219 (26 %) screened positive based on parents’ responses using the English screening criteria. A follow-up interview with those who screened positive resulted 1.4% confirmed positive, 13.7% confirmed negative, and 10.5% remained as screen positive (unable to complete follow-up interview for various reasons such as no contact information provided, did not want to speak to the researcher, or cannot reach parent despite multiple attempts).
Most parents followed-up failed on item 11 (Does your child ever seem oversensitive to noise?) and 18 (Does your child make unusual finger movements near his/her face?) on their initial responses.
Conclusions:
The Korean M-CHAT seems to be a good test to screen for a potential diagnosis of autism for children under age three, when used with a follow-up interview for those items failed.
It will be cost effective to train public health professionals (pediatricians, nurses, day care center personnel) on the use of the Korean M-CHAT. Subsequently, they would administer it during office visits, score it on site, and do a follow-up interview as necessary.
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