title: Predictive Validity of the Modified Checklist for Autism in Toddlers (M-CHAT) Born Very Preterm.
abstract: OBJECTIVE
  To examine the predictive validity of the Modified Checklist for Autism in Toddlers (M-CHAT) administered at age 24 months for autism spectrum disorder (ASD) diagnosed at 10 years of age in a US cohort of 827 extremely low gestational age newborns (ELGANs) followed from birth.
  
  
  METHODS
  We examined the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the M-CHAT in predicting an ASD diagnosis at age 10 years based on gold standard diagnostic instruments. We then assessed how these predictive parameters were affected by sensorimotor and cognitive impairments, socioeconomic status (SES), and emotional/behavioral dysregulation at age 2 years.
  
  
  RESULTS
  Using standard criteria, the M-CHAT had a sensitivity of 52%, a specificity of 84%, a PPV of 20%, and an NPV of 96%. False-positive and false-negative rates were high among children with hearing and vision impairments. High false-positive rates also were associated with lower SES, motor and cognitive impairments, and emotional/behavioral dysregulation at age 2 years.
  
  
  CONCLUSIONS
  Among extremely preterm children with ASD, almost one-half were not correctly screened by the M-CHAT at age 2 years. Sensorimotor and cognitive impairments, SES, and emotional/behavioral dysregulation contributed significantly to M-CHAT misclassifications. Clinicians are advised to consider these factors when screening very preterm toddlers for ASD.
authors: Department of Psychiatry, Weill Cornell Medicine, New York, NY. Electronic address: sok2015@med.cornell.edu.
authors: So Hyun
authors: SH
authors: Kim
authors: Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA.
authors: Robert M
authors: RM
authors: Joseph
authors: Department of Psychiatry and Pediatrics, University of Massachusetts Memorial Health Care and University of Massachusetts Medical School, Boston, MA.
authors: Jean A
authors: JA
authors: Frazier
authors: Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
authors: Thomas M
authors: TM
authors: O'Shea
authors: Yale Child Study Center, Yale University School of Medicine, New Haven, CT.
authors: Katarzyna
authors: K
authors: Chawarska
authors: Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors: Elizabeth N
authors: EN
authors: Allred
authors: Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors: Alan
authors: A
authors: Leviton
authors: Department of Pediatrics, Boston Medical Center, Boston, MA.
authors: Karl K
authors: KK
authors: Kuban
mesh_terms: D000067877:Autism Spectrum Disorder / Q000175:diagnosis*; D057189:Checklist; D002648:Child; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: Autism; M-CHAT; Preterm children; Screening