An Investigation into Referrals Placed Following Positive Screening With the Modified Checklist for Autism in Toddlers, Revised With Follow-up

Vollständiger Abstract

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ABSTRACT Objective: The objective of this study was to examine referral practices after positive autism spectrum disorder screening with the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F) for potential variability based on demographic factors focusing on language and patient-reported need for interpretation. Methods: This was a retrospective cohort study. The study population consisted of 776 patients (mean age 25 months) with a positive M-CHAT-R/F (367 high risk, 409 moderate risk). Data collected included self-reported race, ethnicity, preferred language, interpreter need, screening results, and referrals placed at the time of screening. Patients with a prior autism spectrum disorder diagnosis were excluded. Data were analyzed using Pearson's χ 2 test of independence and logistic regression to determine if demographic factors, focusing on preferred language and need for an interpreter, were associated with placement of recommended referrals. Results: Among children with a positive M-CHAT-R/F screen, 69% were referred to developmental behavioral pediatrics, 76% to behavioral health, 83% for early intervention, 93% for speech therapy, and 91% for audiology. In unadjusted stratified analysis, no significant differences were found in rates of referral to recommended services in relation to race, language spoken, or interpreter need. After a logistic regression analysis, no factors were predictive of higher or lower rates of referral to any service studied. Conclusion: We found no disparities in referrals after a positive M-CHAT-R/F in relation to preferred language or interpreter need. Further research could examine what factors can help prevent disparities in referral placement to recommended services.