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The Developmental Check-in (DCI): A New Visual Autism Screening Tool

Thursday, 2 May 2013: 14:00-18:00
Banquet Hall (Kursaal Centre)
Y. Janvier1, J. Harris2 and D. S. Mandell3, (1)Medicine, Children's Specialized Hospital, Toms River, NJ, (2)Children's Specialized Hospital, Mountainside, NJ, (3)Psychiatry, Center for Mental Health Policy and Services Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
Background: Racial, ethnic and income disparities in early and accurate diagnosis of autism spectrum disorders may be due, at least in part, to the lack of accuracy in these populations of commonly used autism screening tools. Our prior work has shown that poor and ethnic minority parents of young children had poor knowledge of normal development, misinterpreted behaviors that are considered red flags for autism, and had difficulty reading and understanding items on the Modified Checklist for Autism in Toddlers (M-CHAT) and Social Communication Questionnaire.  Based on these findings and with input from focus groups conducted within the underserved communities, we developed a new tool to identify young children with autism, the Developmental Check-In (DCI). The DCI is primarily pictorial and has minimal literacy demands, which reduces literacy, comprehension, cultural, and language-based barriers that may be inherent in traditional screen instruments.

Objectives: to assess the accuracy of a pictorial screening measure, the Developmental Check-In, developed for a low literacy population .

Methods: The Developmental Check-In (DCI), Screening Test for Autism in Toddlers (STAT) which is a level 2 screening instrument, and M-CHAT were administered to 130 children ages 12-48 months referred to outpatient centers for developmental screening/evaluation. Screening was facilitated by an Advanced Practice Nurse, who also made a clinical diagnosis based on DSM IV criteria.

Results: Of the 130 children, 90 children were screened using all 3 tools, 18 were screened using the DCI and STAT only, 14 were screened using the DCI and M-CHAT only, and 8 received DCI only. ROC analysis revealed no difference between the DCI and the M-CHAT.

Conclusions: The DCI, a pictorial autism screening measure was developed for a low literacy population and was first tested in a literate population, finding no difference between it and the M-CHAT. This suggests it has reasonable psychometrics. Tests in a low literacy group are forthcoming. Since the DCI is pictorial and has reduced literacy demands, it may have utility across cultures and thus may help reduce barriers to accessing early diagnosis



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