The Modified Checklist for Autism in Toddlers: Reliability in a Diverse Rural American Sample
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ORIGINAL PAPER
The Modified Checklist for Autism in Toddlers: Reliability in a Diverse Rural American Sample Angela Scarpa • Nuri M. Reyes • Michelle A. Patriquin Jill Lorenzi • Tyler A. Hassenfeldt • Varsha J. Desai • Kathryn W. Kerkering
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Ó Springer Science+Business Media New York 2013
Abstract This study investigated the psychometric properties of the modified checklist for autism in toddlers (M-CHAT) in a diverse rural American low-socioeconomic status (SES) sample. Four hundred and forty-seven English (n = 335) and Spanish (n = 112) speaking caregivers completed the M-CHAT during their toddler’s 18- or 24-month well visit in a Southwest Virginia pediatric clinic. The M-CHAT did not show acceptable internal consistency in groups with low maternal education or minority status. Caregivers reporting low maternal education and minority status were more likely to endorse items suggestive of autism. These results indicate that the M-CHAT may require
A. Scarpa (&) N. M. Reyes M. A. Patriquin J. Lorenzi T. A. Hassenfeldt Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061-0436, USA e-mail: [email protected] N. M. Reyes e-mail: [email protected] M. A. Patriquin e-mail: [email protected] J. Lorenzi e-mail: [email protected] T. A. Hassenfeldt e-mail: [email protected] V. J. Desai Department of Pediatrics, Carilion Clinic, 1030 South Jefferson Street, Suite 106, Roanoke, VA 24016, USA e-mail: [email protected] K. W. Kerkering Department of Pediatrics, Pediatric Neuro-Developmental Clinic, Carilion Clinic, 1030 South Jefferson Street, Suite 201, Roanoke, VA 24016, USA e-mail: [email protected]
modifications to be more internally consistent and accurate across ethnic and educational groups in rural areas with low levels of SES. Recommendations to increase the utility of the M-CHAT are discussed. Keywords M-CHAT Autism screening Reliability Diverse populations
Introduction Autism spectrum disorder (ASD) as defined by diagnostic criteria (American Psychiatric Association [APA] 2000) and first described by Kanner (1943) is considered the fastest growing developmental disability in the United States (Hertz-Picciotto and Delwiche 2009). ASD is characterized by deficits related to social functioning (e.g., Klin et al. 2002), communication (e.g., Demouy et al. 2011), and restricted and repetitive behaviors (Leekam et al. 2011; Kanner 1943). Previous research has suggested that intervention prior to the age of 3 is associated with the best outcomes (Connor 1998). The ability to detect the presence of ASD while an individual is young allows for the possibility of early intervention, which is critical for children with ASD (Wiggins et al. 2006). Given the importance of early diagnosis and intervention, efforts have been devoted to developing measures that may reliably identify autism at an early age. The modified checklist for autism in toddlers (M-CHAT; Robins et al. 2001), a screening tool designed to improve the sensitivity and practicality of the checklist for autism in to
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