Evidence map›Paper›PMID 41506774›Full record

SynthesisBMJ open2026

Narrative systematic review for autism spectrum disorders screening tools in school settings.

Lucy J McCann, Rinad Bakhti, Nishani Fonseka, Dasha Nicholls, Dougal S Hargreaves, Federica Amati, Antonio Ivan Lazzarino, Ritu Mitra, Krishan Narayan, Alex Weston and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 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

11 authors.

Lucy J McCannDepartment of Twin Research & Genetic Epidemiology, King's College London, London, UK lucy.mccann@nhs.net.ORCID http://orcid.org/0000-0002-6495-7747
Rinad BakhtiDepartment of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0009-0003-7824-2181
Nishani FonsekaSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, staffordshire, UK.ORCID http://orcid.org/0000-0001-5955-2211
Dasha NichollsDepartment of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-7257-6605
Dougal S HargreavesSchool of Public Health, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-0722-9847
Federica AmatiSchool of Public Health, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0002-3401-6946
Antonio Ivan LazzarinoCentral and North West London NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-8045-2346
Ritu MitraThe Giaroli Centre, London, UK.
Krishan NarayanInstitute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
Alex WestonListen to Act, London, UK.
Shamini GnaniSchool of Public Health, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-6246-9590

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEarly screening for autism spectrum disorder (ASD) can enhance educational and health outcomes for affected children. This narrative systematic review explores school-based screening tools used around the world to identify children with ASD and explore the differences across socio-demographic groups.

designSystematic review of electronic databases (EMBASE, MEDLINE, PsycINFO, Cochrane and Scopus) in October 2024 of papers published between 2011 and 2024.

settingMainstream school-based settings globally.

participantsChildren aged 4-16 years old attending mainstream school.

interventionsSchool-based screening tools for ASD, including all types of informant and format of tools reported in eligible studies. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes included prevalence of screen positives, sensitivity and specificity of the screening tools. Secondary outcomes included participants' sex, socioeconomic status and ethnicity, and the relation of this to the primary outcomes.

resultsOf 7765 eligible articles, 14 studies were included in this review. We identified eight different school-based ASD screening tools. Study populations ranged from 103 to 16 556 children, with sensitivity and specificity varying by screening tool used, age group, setting and ASD prevalence. The percentage of children screening positive for ASD ranged from 0.7% to 8.5%. Studies were conducted in Europe (n=6), Western Pacific (n=4), the Americas (n=3) and Eastern Mediterranean (n=1) regions. No studies explicitly explored accuracy or validity outcomes based on ethnicity or socioeconomic status. Half of the 14 studies (n=7) reported the sensitivity and specificity of the screening tools; sensitivity ranged from 58% to 94% and specificity from 61% to 100%. There was insufficient evidence to recommend any single ASD screening tool.

conclusionsASD screening tools vary widely across the globe, with limited standardisation. Evidence is lacking on how ethnicity and socioeconomic status affect their effectiveness in schools. Given the dearth of scientific evidence in this field, collaboration among educators, researchers and policymakers is needed to establish the evidence base for universal screening, identify optimal tools, coordinate their use and ensure their validation for specific populations.

Indexed as

Autism Spectrum DisorderMass ScreeningSchool Health ServicesAdolescentChildChild, PreschoolHumansPrevalenceSchoolsSensitivity and SpecificityPUBLIC HEALTHSchoolsSensitivity and Specificity

Identifiers

PMID41506774
PMCPMC13059882

What OpenQuestion holds

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LicenceCC BY
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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.