ArticleAutism research : official journal of the International Society for Autism Research2022
What are we optimizing for in autism screening? Examination of algorithmic changes in the M-CHAT.
Article in Autism research : official journal of the International Society for Autism Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Comparative screening accuracy of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-Chat-R/F) for early autism spectrum disorder: a systematic review.Family medicine and community health · 2026Pooled it
- Sensitivity and Specificity of the Modified Checklist for Autism in Toddlers (Original and Revised): A Systematic Review and Meta-analysis.JAMA pediatrics · 2023Pooled it
- The Impact of Using Standardized Autism Screening on Referral to Specialist Evaluation for Young Children on the Autism Spectrum: A Cluster-Randomized Controlled Trial.Journal of the American Academy of Child and Adolescent Psychiatry · 2025Trial
- Implementation of M-Chat for Screening of Early Signs of Autism in the Brazilian Health Care System: A Feasibility Study.Nursing reports (Pavia, Italy) · 2025Article
- The influence of loss to follow-up in autism screening research: Taking stock and moving forward.Journal of child psychology and psychiatry, and allied disciplines · 2024Article
- Clinical, socio-demographic, and parental correlates of early autism traits in a community cohort of toddlers.Scientific reports · 2024Article
- Early Prediction of Autistic Spectrum Disorder Using Developmental Surveillance Data.JAMA network open · 2024Article
- Diagnosis of Autism in Children Based on their Gait Pattern and Movement Signs Using the Kinect Sensor.Journal of medical signals and sensors · 2024Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
The present study objectives were to examine the performance of the new M-CHAT-R algorithm to the original M-CHAT algorithm. The main purpose was to examine if the algorithmic changes increase identification of children later diagnosed with ASD, and to examine if there is a trade-off when changing algorithms. We included 54,463 screened cases from the Norwegian Mother and Child Cohort Study. Children were screened using the 23 items of the M-CHAT at 18 months. Further, the performance of the M-CHAT-R algorithm was compared to the M-CHAT algorithm on the 23-items. In total, 337 individuals were later diagnosed with ASD. Using M-CHAT-R algorithm decreased the number of correctly identified ASD children by 12 compared to M-CHAT, with no children with ASD screening negative on the M-CHAT criteria subsequently screening positive utilizing the M-CHAT-R algorithm. A nonparametric McNemar's test determined a statistically significant difference in identifying ASD utilizing the M-CHAT-R algorithm. The present study examined the application of 20-item MCHAT-R scoring criterion to the 23-item MCHAT. We found that this resulted in decreased sensitivity and increased specificity for identifying children with ASD, which is a trade-off that needs further investigation in terms of cost-effectiveness. However, further research is needed to optimize screening for ASD in the early developmental period to increase identification of false negatives.
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Registered trials
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