The Autism Society Event and Education Recordings Archive

The current recommendation is for autism screening to be completed for all children beginning at age 18 months (Johnson & Myers, 2007). This screening is to be completed during regularly scheduled visits with the pediatrician. Currently 8% of pediatricians screen for autism, at an average age of 48 months (Wiggins, Baio, & Rice, 2006; Dosreis, Weiner, & Newschaffer, 2008). In addition to this disturbing data, 32% of children who are screened positive for autism by a pediatrician do not pursue additional clinical evaluation as recommended (Dietz, Swinkels, Van Daalen, Van Engeland, & Buitelaar, 2007). The screening process for autism must be improved.

More than 8 million children under the age of five are enrolled in licensed childcare settings in the United States (U.S. Census, 2005). These settings may provide an excellent opportunity to provide autism screening. Autism screening can be easily completed via a parental report with an empirically validated screening tool (Robins, Fien, & Barton, 1999). Formal childcare settings frequently work with parents to identify developmental concerns and support families to identify appropriate resources to address these concerns. Given the current prevalence of autism, screening for this disability within childcare settings may be plausible.

A pilot study was completed to assess a process for autism screening in community childcare settings. IRB approval was obtained via consultation with a developmental behavioral pediatrician at Nationwide Children’s Hospital in Columbus Ohio. Childcare centers were recruited within the Easter Seals Child Development Center Network. The Easter Seals Child Development Center Network serves 7,000 young children, age six weeks to six years, in approximately 80 centers throughout the United States. The Child Development Center’s participation in the pilot project was voluntary. Interested Child Development Center Directors received two hours of distance education via WebEx technology. The content of the distance delivery training included a general overview of autism screening and tool-specific training on the use of the Modified Checklist for Autism in Toddlers (M-CHAT) and the M-CHAT Follow-Up Interview. The M-CHAT and M-CHAT Follow-Up Interview in both English and Spanish were distributed to the participating centers as well as the consent to participate in research to be signed by parents completing the M-CHAT.

The childcare centers distributed the M-CHAT to children age 16-30 months per the validity of the M-CHAT. Distribution was exclusive to families that spoke either English or Spanish. The childcare centers then collected the completed M-CHAT’s, scored the completed screenings and shared results with families. Protocol for positive results included completion of the M-CHAT Follow-Up Interview. The M-CHAT Follow-up Interview was completed by the parent of the child who screened positive and the childcare center director. Upon a positive post-interview, written and verbal recommendations for follow-up with both early intervention specialists and their medical provider were delivered directly to the parent by the center director. One-, 3- and 6-month follow-up data was collected from participating children. This data was an effort to preliminarily assess sensitivity/specificity. 

This session will share the results of this pilot study. Quantitative information about rate of return and results of screening will be shared. Comparison to published data regarding sensitivity and specificity will be discussed. In addition, qualitative information gathered from the participating childcare center directors will be provided. Future research recommendations will also be provided.