Autism Screening in “Real-World” Settings Misses a Lot of Kids

Statewide systems for tiered autism evaluations may be one solution.

Although validated screening instruments for autism spectrum disorder (ASD), such as the Modified Checklist for Autism in Toddlers (MCHAT), work well in research populations, their performance may be lower in “real-world” settings. To test this, researchers examined electronic medical record (EMR) data from children who had 18- or 24-month well-child visits from 2013 to 2016 in a large health system. The MCHAT, embedded in the EMR, was used in 73% of over 36,000 toddlers during that time frame. Screening occurred less frequently in Hispanic toddlers and by family medicine providers.

The same toddlers' charts were subsequently reviewed for ASD diagnosis codes in 2019, at ages 4.75 and older. Although having a positive screen led to tenfold hi…

Reviewing Author

Jenny Radesky, MD

Disclosures

Consultant/Advisory BoardMelissa & Doug Toys (Consultant and Board of Directors)

Grant/Research SupportNational Institute for Child Health and Development; National Institutes of Health

Jenny Radesky, MD

Disclosures

Consultant/Advisory BoardMelissa & Doug Toys (Consultant and Board of Directors)

Grant/Research SupportNational Institute for Child Health and Development; National Institutes of Health

Autism Screening in “Real-World” Settings Misses a Lot of Kids

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Reviewing Author