SynthesisFamily medicine and community health2026
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.
Synthesis in Family medicine and community health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Failure points in the early autism identification pathway for children aged 0-5 years: Why screening is not diagnosis.Pediatric investigation · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEarly screening for autism spectrum disorder (ASD) is critical for timely intervention, making the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) a widely adopted tool globally. However, a recent systematic synthesis of its comparative accuracy is lacking. This review aimed to evaluate the screening accuracy of the M-CHAT-R/F against other ASD screening instruments.
designA systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A narrative synthesis was employed to integrate findings across diverse study designs and methodological quality was assessed using the Joanna Briggs Institute checklist. ELIGIBILITY CRITERIA: Peer-reviewed, English-language observational studies published between January 2020 and October 2025 that compared the accuracy metrics of the M-CHAT-R/F with alternative screening tools. INFORMATION SOURCES: Scopus, PubMed, ScienceDirect and ProQuest.
resultsFrom 172 identified articles, six high-quality studies encompassing 12 633 participants aged 12-48 months were analysed. The synthesis revealed a complex performance profile for the M-CHAT-R/F. While its sensitivity for detecting potential cases was highly inconsistent, its negative predictive value remained consistently high, reliably identifying children who screened negative. Conversely, the tool demonstrated variable specificity and a persistently low positive predictive value, indicating a substantial false-positive burden and reduced confidence in positive results. Furthermore, the M-CHAT-R/F's accuracy was highly age-dependent, with performance degrading outside the optimal 16-30-month window compared with other specialised tools.
conclusionsThe M-CHAT-R/F may not be an optimal instrument in every clinical setting. Its clinical utility may be limited by variable sensitivity and a lower positive predictive value, potentially creating a higher false-positive burden. Clinicians and health systems should consider adopting age-specific, tiered screening protocols to improve diagnostic efficiency and better allocate intervention resources.
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