I chose to research this article because I teach an entire class of students with Autism and I am always interested in the age they were diagnosed with Autism and how their parents interpreted thier diagnosis. The article discussed two levels of screening used to diagnosis Autism which include broad-based developmental surveillance and targeted screening. Two popular tools for use in developmental surveillance are the Checklist for Autism in Toddlers (CHAT) and the Modified Checklist for Autism in Toddlers (M-CHAT). The research conducted in this article compared these two tests and the evidence of an advantage for using the M-CHAT. The research proved that the M-CHAT had better predictive accuracy than the CHAT.
To further elaborate on each test, I would like to provide a brief description of both. The CHAT tool was developed to identify Autism based on parent's reports of child behavior and also observed behavior by a health professional at 18 months of age. The CHAT tool consists of 14 questions and is divided into two sections. The questions in Section A are answered by the parents and focus on areas that are usually impaired in a child with Autism. These questions include subjects such as motor development, social play, functional play, protoimperative pointing, and joint attention. Section B of the test are answered by the heatlh practitioner and include questions such as prodeclarative pointing, gaze monitoring, and pretend play. CHAT is usually used twice to screen Autism, once at baseline and a month after baseline screeing. CHAT has also been determined to identify children with Developmental Disorders.
On the other hand, the M-CHAT tool differs in it's design in which the observation portion of the assessment is eliminated and questions based on parent's reports of behavior are expanded. The M-CHAT consists of 23 yes/no questions evaluating the child's behavior. The questions include items such as sensory abnormalities, motor abnormalities, social interaction, playing ability, and communication ability. Screen positive is defined as failing any 3 items or any 2 out of 6 critical items. Critical items are those related to joint attention, declaritive pointing, social relatedness, and communication. Combining the M-CHAT with an interview improved detection of Autism.
To summarize, evidence in this article confirms the importance of screening for Autism during the ages of 18-24 month period. However, complexity in the diagnosis using these tools may occur in children who have both Autism and developmental problems. In children with both Autism and developmental delays, characteristics of Austims may not be found, as their skills to show this behavior have not yet developed. Evidence from this article also suggests that the M-CHAT has slightly better sensitivity and specificity compared to CHAT and is preferable to use by parent's in screening. The connection of this article to Chapter 6 is that both discuss identification of Students with Emotional and Behavioral disabilities and various forms of screenings. For example, Chapter 6 discusses the use of a Functional Behavior Assessment, which helps to identify events, activities, and situations associated with a student's problem behaviors. In my own personal experience as a teacher, many of my student's with Autism have been issued an FBA. The Behavior Therapist and teacher's discuss the results of the FBA and adress replacement behaviors and environmental adjustments to meet my student's needs. This article proved to be very practical because it gave me a better understanding of the procedures parent's in my classroom had to follow in order to develop a diagnosis for their child.
Bilszta, J., Early Identification of Autism: A comparison of the Checklist for Autism in Toddlers & the Modified Checklist for Autism in Toddlers. Journal of Pediatrics and Child Health. (2013) Pg. 438-444
