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In Event: Special Poster Session 05 with Continental Breakfast Reception
In Poster Session: PS 05 - Policy Section
Introduction. Children with Autism Spectrum Disorder (ASD) benefit from early, intensive ASD-specific intervention (Anderson, Liang, & Lord, 2014; MacDonald, Parry-Cruwys, Dupere, & Ahearn, 2014; Rogers & Vismara, 2008), yet provision of these services is contingent upon early diagnosis. The American Academy of Pediatrics (AAP) recommends screening at 18 and 24 months; however, to date, there is no research regarding the incremental utility of repeated screening after a negative (i.e., not at-risk) screening at 18 months. The present study aimed to (1) identify cases of ASD detected at 24 months after a negative 18-month screening (i.e., Catch-24 Group) and (2) compare Catch-24 children to those detected by 18-month screening (i.e., Early Diagnosis Group).
Methods. Participants were screened with either the Modified Checklist for Autism in Toddlers with Follow-Up (M-CHAT/F) or its revision, the M-CHAT-R/F, at their 18-month pediatric well-child care visit (n = 19,685), or at both their 18- and 24-month well-child care visits (n = 7,993; 7,781 of these children screened negative at 18 months). Children who screened positive (i.e., at-risk for ASD) were offered a free evaluation to assess developmental level, adaptive skills, and ASD symptoms.
Results. Of the 7,781 children who screened negative at 18 months and were rescreened at 24 months, 0.4% (n = 32) screened positive at 24 months. Ten of these children, or 0.1% of the entire rescreening sample, received an ASD diagnosis (i.e., Catch-24 Group). Overall, of the children who screened negative at 18 months and positive at 24 months, who were subsequently evaluated (n = 20), 80% received a developmental diagnosis warranting intervention (including the 10 toddlers with ASD), and only 20% were typically developing. The Catch-24 children had greater ASD severity (Autism Diagnostic Observation Schedule calibrated severity score M = 8.00, SD = 1.31), with a small to medium effect, (t(186) = -2.73, p = .01, η2 = .04), than the Early Diagnosis children (M = 6.04, SD = 2.01). However, groups demonstrated comparable cognitive and adaptive abilities. Similarly, groups did not differ on child gender, race/ethnicity, maternal education, or annual household income.
Discussion: Despite a relatively low yield of ASD cases at 24 months after negative 18-month screening, this study supports the current AAP recommendations that all children be routinely screened at both their 18- and 24-month well-child care visits, in order to maximize identification of at-risk toddlers. The opportunity to identify additional children who would likely benefit from early intervention, in our view, outweighs the risks and possible inconveniences of executing this repeated screening procedure.
Yael Dai, University of Connecticut
Lauren Miller, University of Connecticut
Riane K. Ramsey, Georgia State University
Diana Robins, Drexel University
Deborah Fein, University of Connecticut
Thyde Dumont-Mathieu, Connecticut Children’s Medical Center