Evaluating screening for autism spectrum disorder using cluster randomization.

Autism spectrum disorder Cluster randomization M-CHAT-R/F Screening Usual care

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
21 Mar 2024
Historique:
received: 28 06 2023
accepted: 20 03 2024
medline: 22 3 2024
pubmed: 22 3 2024
entrez: 22 3 2024
Statut: epublish

Résumé

We evaluated the rate of autism spectrum disorder (ASD) in a group invited to a screening program compared to the rates in two groups who received usual care. The population eligible for screening was all children in Iceland registered for their 30-month well-child visits at primary healthcare centers (PHCs) from March 1, 2016, to October 31, 2017 (N = 7173). The PHCs in the capital area of Reykjavik were the units of cluster randomization. Nine PHCs were selected for intervention (invited group), while eight PHCs received usual care (control group 1). PHCs outside the capital area were without randomization (control group 2). An interdisciplinary team, including a pediatrician contributing with physical and neurological examination, a psychologist evaluating autism symptoms using a diagnostic instrument, and a social worker interviewing the parents, reached a consensus on the clinical diagnosis of ASD according to the ICD-10 diagnostic system. Children in the population were followed up for at least two years and 119 cases were identified. The overall cumulative incidence of ASD was 1.66 (95% confidence interval (CI): 1.37, 1.99). In the invited group the incidence rate was 2.13 (95% CI: 1.60, 2.78); in control group 1, the rate was 1.83 (95% CI: 1.31, 2.50); and in control group 2, the rate was 1.02 (95% CI: 0.66, 1.50). Although the rate of ASD was higher in the invited group than in the control groups, the wide confidence intervals prevented us from concluding definitively that the screening detected ASD more readily than usual care.

Identifiants

pubmed: 38514752
doi: 10.1038/s41598-024-57656-0
pii: 10.1038/s41598-024-57656-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

6855

Informations de copyright

© 2024. The Author(s).

Références

Garcia-Primo, P. et al. Screening for autism spectrum disorders: State of the art in Europe. Eur. Child Adolesc. Psychiatry 23(11), 1005–1021 (2014).
doi: 10.1007/s00787-014-0555-6 pubmed: 24913785 pmcid: 4229652
Soto, S. et al. A review of cultural adaptations of screening tools for autism spectrum disorders. Autism 19(6), 646–661 (2015).
doi: 10.1177/1362361314541012 pubmed: 25008216
Stewart, L. A. & Lee, L. C. Screening for autism spectrum disorder in low- and middle-income countries: A systematic review. Autism 21(5), 527–539 (2017).
doi: 10.1177/1362361316677025 pubmed: 28183195
Robins, D. L., Fein, D. & Barton, M. The Modified Checklist for Autism in Toddlers Revised with Follow-Up (M-CHAT-R/F). https://mchatscreen.com/ (2009).
Guo, C. et al. Reliability and validity of the Chinese version of Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F). J. Autism Dev. Disord. 49(1), 185–196 (2019).
doi: 10.1007/s10803-018-3682-y pubmed: 30047095
Oner, O. & Munir, K. M. Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an urban metropolitan sample of young children in Turkey. J. Autism Dev. Disord. 50(9), 312–3319 (2020).
doi: 10.1007/s10803-019-04160-4
Magán-Maganto, M. et al. Spanish cultural validation of the Modified Checklist for Autism in Toddlers, Revised. J. Autism Dev. Disord. 50(7), 2412–2423 (2020).
doi: 10.1007/s10803-018-3777-5 pubmed: 30328577
Robins, D. L. et al. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). Pediatrics 133(1), 37–45 (2014).
doi: 10.1542/peds.2013-1813 pubmed: 24366990 pmcid: 3876182
Sangare, M. et al. Validation of two parent-reported autism spectrum disorders screening tools M-CHAT-R and SCQ in Bamako, Mali. eNeurologicalsci. 15, 100188 (2019).
doi: 10.1016/j.ensci.2019.100188 pubmed: 30923752 pmcid: 6423411
Windiani, I. G. T., Soetjiningsih, S., Adnyana, I. G. A. S. & Lestari, K. A. Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for autism screening in children at Sanglah General Hospital, Bali-Indonesia. Bali Med. J. 5(2), 311–315 (2016).
doi: 10.15562/bmj.v5i2.240
Raffle, A. E. & Gray, J. A. M. Screening: Evidence and Practice (Oxford University Press, 2007).
doi: 10.1093/acprof:oso/9780199214495.001.0001
McClure, L. A. et al. Connecting the dots: A cluster-randomized clinical trial integrating standardized autism spectrum disorders screening, high-quality treatment, and long-term outcomes. Trials 22(1), 319 (2021).
doi: 10.1186/s13063-021-05286-6 pubmed: 33934719 pmcid: 8091523
Jonsdottir, S. L. et al. Implementing an early detection program for autism in primary healthcare: Screening, education of healthcare professionals, referrals for diagnostic evaluation, and early intervention. Res. Autism Spectr. Disord. 77, 101616 (2020).
doi: 10.1016/j.rasd.2020.101616
Jonsdottir, S. L., Saemundsen, E., Jonsson, B. G. & Rafnsson, V. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up in a population sample of 30-month-old children in Iceland: A prospective approach. J. Autism Dev. Disord. 52(4), 1507–1522 (2022).
doi: 10.1007/s10803-021-05053-1 pubmed: 33945117
Delobel-Ayoub, M. et al. Prevalence of autism spectrum disorder in 7-9-year-old children in Denmark, Finland, France and Iceland: A population-based registries approach within the ASDEU project. J. Autism Dev. Disord. 50(3), 949–959 (2020).
doi: 10.1007/s10803-019-04328-y pubmed: 31813107
Directorate of Health. Participation in general vaccinations for children in Iceland 2020. Final report for 2021 [in Icelandic]. https://www.landlaeknir.is/servlet/file/store93/item47721/%C3%9E%C3%A1tttaka%20%C3%AD%20almennum%20b%C3%B3lusetningum%20barna%20%C3%A1%20%C3%8Dslandi%202020.pdf (2021).
Development Center for Primary Healthcare in Iceland. Guidelines on child healthcare [in Icelandic]. http://www.throunarmidstod.is/svid-thih/ung-og-smabarnavernd/ (2016).
Glascoe, F. P. Parents’ Evaluation of Developmental Status [in Icelandic] (Námsmatsstofnun & Landlæknisembættið, 2009).
Brigance, A. H. Brigance Early Childhood Screen II [in Icelandic] (Embætti landlæknis, Þróunarsvið, Þroska- og hegðunarstöð Heilsugæslu höfuðborgarsvæðisins, 2017).
Ministry of Education. The Preschool Act no. 90/2008. https://www.government.is/media/menntamalaraduneyti-media/media/MRN-pdf_Annad/Preschool_Act.pdf (2008).
Statistics Iceland. Fewer licenced preschool teachers. https://www.statice.is/publications/news-archive/education/children-and-staff-in-pre-primary-schools-2018/ (2019).
Ministry of Education. Compulsory School Act no. 91/2008. https://www.government.is/media/menntamalaraduneyti-media/media/law-and-regulations/Compulsory-School-Act-No.-91-2008.pdf (2008).
Ministry of Welfare. The Social Security Act no. 100/2007. https://www.government.is/library/04-Legislation/Social%20Security%20Act%20100%202007%20with%20subsequent%20amendments%202018%20n%c3%b3vember.pdf (2007).
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research (World Health Organization, 1993).
Lord, C. et al. Autism Diagnostic Schedule, Second Edition (ADOS-2) Manual (Part I): Modules 1–4 (Western Psychological Services, 2012).
Gudmundsson, E. & Olafsdottir, H. Weschler Preschool and Primary Scale of Intelligence, Revised. Manual for the Icelandic standardization [in Icelandic] (Námsmatsstofnun, 2003).
Bayley, N. Bayley Scales of Infant and Toddler Development 3rd edn. (Harcourt Assessment, Psych. Corp., 2006).
Martin, D. O. & Austin, H. Exact estimates for a rate ratio. Epidemiology 7(1), 29–33 (1996).
doi: 10.1097/00001648-199601000-00006 pubmed: 8664397
Zeidan, J. et al. Global prevalence of autism: A systematic review update. Autism Res. 15(5), 778–790 (2022).
doi: 10.1002/aur.2696 pubmed: 35238171 pmcid: 9310578
Schendel, D. E. & Thorsteinsson, E. Cumulative incidence of autism into adulthood for birth cohorts in Denmark, 1980–2012. JAMA 320(17), 1811–1813 (2018).
doi: 10.1001/jama.2018.11328 pubmed: 30398592 pmcid: 6248103
Rydzewska, E. et al. Age at identification, prevalence and general health of children with autism: Observational study of a whole country population. BMJ Open 9(7), e025904 (2019).
doi: 10.1136/bmjopen-2018-025904 pubmed: 31289063 pmcid: 6629388
Shaw, K. A. et al. Early identification of autism spectrum disorder among children aged 4 years—Early Autism and Developmental Disabilities Monitoring Network, six sites, United States, 2016. MMWR Surveill. Summ. 69(3), 1–11 (2020).
doi: 10.15585/mmwr.ss6903a1 pubmed: 32214087 pmcid: 7119644
Siu, A. L. et al. Screening for autism spectrum disorder in young children: US Preventive Services Task Force recommendation statement. JAMA 315(7), 691–696 (2016).
doi: 10.1001/jama.2016.0018 pubmed: 26881372
Hsu, Y. H., Chen, C. W., Lin, Y. J. & Li, C. Y. Urban-rural disparity in the incidence of diagnosed autism spectrum disorder in Taiwan: A 10-year national birth cohort follow-up study. J. Autism Dev. Disord. 53(5), 2127–2137 (2023).
doi: 10.1007/s10803-022-05453-x pubmed: 35132529
Lauritsen, M. B. et al. Urbanicity and autism spectrum disorders. J. Autism Dev. Disord. 44(2), 394–404 (2014).
doi: 10.1007/s10803-013-1875-y pubmed: 23807204 pmcid: 4511947
Luo, Y. et al. Urbanicity and autism of children in China. Psychiatry Res. 286, 112867 (2020).
doi: 10.1016/j.psychres.2020.112867 pubmed: 32120171
Williams, J. G., Higgins, J. P. & Brayne, C. E. Systematic review of prevalence studies of autism spectrum disorders. Arch. Dis. Child. 91(1), 8–15 (2006).
doi: 10.1136/adc.2004.062083 pubmed: 15863467
Bjarnason, Þ. University location and the regional gap in university education [in Icelandic]. Netla. https://netla.hi.is/greinar/2018/ryn/01.pdf (2018).

Auteurs

Sigridur Loa Jonsdottir (SL)

State Diagnostic and Counseling Center, Dalshraun 1B, 220, Hafnarfjordur, Iceland. sigridur.l.jonsdottir@rgr.is.
Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. sigridur.l.jonsdottir@rgr.is.

Evald Saemundsen (E)

State Diagnostic and Counseling Center, Dalshraun 1B, 220, Hafnarfjordur, Iceland.
Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

Elin Astros Thorarinsdottir (EA)

Department of Psychology, University of Iceland, Reykjavík, Iceland.
Center of Children's Mental Health, Reykjavík, Iceland.

Vilhjalmur Rafnsson (V)

Department of Preventive Medicine, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

Classifications MeSH