ArticleJournal of autism and developmental disorders2026
Children Classified as Medium-Risk by the M-CHAT-R at Age Two Years Have an Increased Likelihood of Subtle but Widespread Developmental Challenges at Preschool Entry: Results From the French National Birth Cohort ELFE.
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.
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Abstract
backgroundThe Modified Checklist for Autism in Toddlers - Revised (M-CHAT-R) is widely used for screening children at age 2 for autism spectrum disorders (ASD), but it also identifies children at risk for broader developmental challenges. We aimed to examine whether M-CHAT-R risk status at age 2 is associated with cognitive, behavioral, adaptive, and school-related outcomes at ages 3 to 4.
methodsWe used data from the French national birth Cohort ELFE, including children assessed with the M-CHAT-R at age 2. Children were classified as low or medium risk. Outcomes at ages 3-4 included general cognitive development (Child Development Inventory), non-verbal reasoning (Picture Similarities test), family and daily activities, school engagement and performance, attention regulation (teacher-rated ADHD symptoms), specific neurodevelopmental care and school-based assistance. Multivariate analyses used modified Poisson regression for binary outcomes and linear regression for continuous outcomes, adjusted for sociodemographic, child-related, and school-related factors.
findings9,223 children were classified as low-risk and 1,248 children as medium-risk. Medium-risk children were more often boys and from socioeconomically disadvantaged families. At 3.5 years, medium-risk children had increased likelihood of developmental delay (16.6% vs. 6.1%, RR 2.2 after adjustment) and lower cognitive and language scores (up to -0.4 SD). Despite these differences, most children attended school, and their school life was similar to that of low-risk peers.
interpretationChildren classified as medium-risk by the M-CHAT-R at age 2 have an increased likelihood of subtle but widespread developmental challenges at school entry. Strategies to improve access to neurodevelopmental care and school support could enhance outcomes for this group.
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