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Standardized Screening Facilitates Timely Diagnosis of Autism Spectrum Disorders in a Diverse Sample of Low-Risk Toddlers

Herlihy, Lauren E. MA*; Brooks, Bianca BA; Dumont-Mathieu, Thyde MD*; Barton, Marianne L. PhD*; Fein, Deborah PhD*; Chen, Chi-Ming PhD*; Robins, Diana L. PhD

Journal of Developmental & Behavioral Pediatrics: February/March 2014 - Volume 35 - Issue 2 - p 85–92
doi: 10.1097/DBP.0000000000000014
Original Article

Objective: Routine, standardized screening for autism spectrum disorder (ASD) has been hypothesized to reduce known racial/ethnic and socioeconomic status (SES) disparities in age of first diagnosis. This study explored demographic differences in toddlers' age and performance on developmental measures at the time of ASD assessment.

Method: Toddlers (16–39 months at evaluation) who screened at-risk for developmental delay on the Modified Checklist for Autism in Toddlers (M-CHAT) or M-CHAT-Revised (M-CHAT-R) and follow-up interview participated in a diagnostic assessment. Of these, 44.7% were racial/ethnic minorities and 53.5% were non-minorities. Child race/ethnicity, years of maternal education (MEd), and household yearly income (YI) were parent-reported.

Results: Small but significant correlations were observed between MEd or YI and evaluation age and adaptive communication, socialization, and motor scores. Controlling for MEd and YI, minority racial/ethnic group did not predict child's performance on most measures and did not predict likelihood of ASD diagnosis. Differences in age at evaluation and receptive language skills were small effects.

Conclusion: Significant but small effects emerged for SES and minority status on toddlers' age at evaluation and parent-reported adaptive skills, but these did not predict ASD diagnosis. The small magnitude of these effects suggests that routine, standardized screening for ASD in toddlers and timely access to diagnostic evaluation can reduce disparities in age at diagnosis and possibly reduce racial/ethnic disparities in access to services for ASD and other developmental delays.

*Department of Psychology, University of Connecticut, Storrs, CT;

Departments of Clinical Psychology and Neuroscience, Georgia State University, Atlanta, GA.

Address for reprints: Lauren E. Herlihy, MA, Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020 Storrs, CT 06269-1020; e-mail:

Disclosure: D.L. Robins is co-owner of M-CHAT LLC, which licenses use of the M-CHAT in electronic products. Data used in the current study were collected using the free version of the M-CHAT and no royalties are associated with this study. M.L. Barton and D. Fein are co-owners of the M-CHAT LLC, and donate their proceeds to the University Foundation and Psychological Services Clinic. The remaining authors declare no conflict of interest. This study is supported by current National Institutes of Health (NIH) Grant HD39961, past NIH Grants F31 MH12550 and R40 MC00270, past grants from the Department of Education, the National Alliance for Autism Research, and CDC-GSU.

Received December , 2012

Accepted October , 2013

© 2014 by Lippincott Williams & Wilkins