Evidence map›Paper›PMID 38995481›Full record

ArticleJournal of autism and developmental disorders2026

Brief Report: Relationships Between Caregiver-Reported Externalizing and Internalizing Behaviors and the Modified Checklist for Autism in Toddlers.

Jane Marryat, Naomi O Davis, Reginald Lerebours, Kimberly L H Carpenter, Scott Compton, Brian Eichner, Lauren Franz, Scott H Kollins, Marina Spanos, Geraldine Dawson

Abstract read
In one paragraph

Article in Journal of autism and developmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jane MarryatDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0001-9187-6806
Naomi O DavisDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA. naomi.davis@duke.edu.
Reginald LereboursDepartment of Biostatistics and Bioinformatics, Duke University, 415 Chapel Drive, Durham, NC, 27705, USA.
Kimberly L H CarpenterDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.
Scott ComptonDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0003-2887-9582
Brian EichnerDuke University School of Medicine, 8 Searle Center Drive, Durham, NC, 27705, USA.
Lauren FranzDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0003-4434-7500
Scott H KollinsDuke University School of Medicine, 8 Searle Center Drive, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0001-6847-6935
Marina SpanosDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0002-4601-8498
Geraldine DawsonDepartment of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0003-1410-2764

Funding

Recruitment and Assessment CoreP50HD093074 · NICHD · DUKE UNIVERSITY · PI SCOTT N COMPTON · 2017 to 2026
$27.6M
National Institute of Child Health and Human Development 2P50HD093074NICHD NIH HHS P50 HD093074
6 · The paper itself

Abstract

purposeEarly detection and intervention are associated with improved outcomes for autistic children. Thus, it is important to understand factors influencing early screening tools designed to detect autism. This study examined the relationship between caregiver-reported emotional and behavioral symptoms and children's scores on a commonly used autism screening questionnaire, the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F).

methodsToddlers were recruited from four primary care clinics between 2018 and 2021. Their caregivers completed the M-CHAT-R/F as well as the Child Behavior Checklist (CBCL), a well-validated, normed measure of emotional and behavioral functioning. Correlational and group analyses were evaluated to examine relationships between CBCL scales and M-CHAT-R/F scores.

results1765 toddlers were recruited for the study. CBCL scores for the internalizing, externalizing, autism, ADHD, and anxiety scales were all modestly positively correlated with M-CHAT-R/F scores. Compared to toddlers with elevated autism scale scores only, toddlers with elevations in both autism and ADHD/externalizing scales had higher M-CHAT-R/F scores. In contrast, no significant difference in scores were found between toddlers with elevated autism scale scores only compared to those with elevated scores on both autism and internalizing scales.

conclusionFindings suggest that, for children with elevated autism behaviors, the presence of externalizing symptoms, including ADHD-related concerns, is associated with elevated scores on the M-CHAT-R/F. In contrast, internalizing symptoms did not show an association with elevated M-CHAT-R/F scores among toddlers with elevated autism-related behaviors. Interpretation of the M-CHAT-R/F should include consideration of co-occurring psychiatric conditions, especially externalizing conditions such as ADHD.

Indexed as

Autism Spectrum DisorderAutistic DisorderCaregiversChild BehaviorAnxietyAttention Deficit Disorder with HyperactivityChecklistChild, PreschoolFemaleHumansInfantMaleSurveys and QuestionnairesADHDAnxietyAutismPediatricsScreening

Identifiers

PMID38995481
PMCPMC11913061

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.