Commonly Used ASD Screening Tests
| Autism Screening Tests . | Description . | Age Range . | Average No. Items . | Administration Time . | Forms Available EHR compatible . | Psychometric Properties . | Scoring Method . | Cultural Considerations . | Source . | Key References . |
|---|---|---|---|---|---|---|---|---|---|---|
| M-CHAT-R/F | Parent-completed questionnaire designed to identify children at risk for autism from the general population; follow-up clinician-administered questions and repeat questionnaire required for specificity | 16–30 mo | 20 | 5–10 min | Yes | Standardization sample included 16 071 children screened; 115 had positive screen results, 348 needed evaluation, 221 were evaluated, and 105 diagnosed with an ASD; validated by using the ADI-R, ADOS-G, CARS, and DSM-IV-TR; sensitivity: 0.91; specificity: 0.95 for low-risk 18- and 24-mo-old children with follow-up questionnaire and interview; 45% of children with a score ≥3 on the initial screen and ≥2 on follow-up had ASD; 95% had clinically significant developmental delay | Risk categorization for questionnaire (pass/need interview/ fail); after interview (pass/fail) | Available in multiple languages; see test information for details | http://mchatscreen.com/ | Ref 51 |
| SCQ | Parent-completed questionnaire; designed to identify children at risk for ASD from the general population; based on items in the ADI-R | 4+ y | 40 | 5–10 min | No | Validated by using the ADI-R and DSM-IV on 200 subjects (160 with pervasive developmental disorder, 40 without pervasive developmental disorder); for use in children with mental age of at least 2 y and chronologic age 4+ y; available in 2 forms: lifetime and current. overall test: sensitivity: 0.85 (moderate), specificity: 0.75 (moderate); sensitivity can be improved with lowering cutoff for children younger than 5 y and 5–7 y, specificity poor for younger children | Risk categorization (pass/fail) | Available in multiple languages; see test information for details. | Western Psychological Corporation: www.wpspublish.com | Refs 77 and 572 |
| STAT | Clinician-directed, interactive, and observation measure; requires training of clinician for standardized administration; not for population screening | 24–35 mo; <24 mo (exploratory) | 12 | 20–30 min | No | Validated by comparison with ADOS-G results in 52 children 24–35 mo (26 with autism, 26 with developmental delay); sensitivity: 0.83, specificity: 0.86, PPV: 0.77, NPV: 0.90, for <24 mo: sensitivity: 0.95, specificity: 0.73, PPV: 0.56, NPV: 0.97; screening properties improved for children >14 mo | 12 activities to observe early social-communicative behavior; risk categorization (high risk/low risk) | English | http://stat.vueinnovations.com/ | Refs 573 and 574 |
| Promising autism screening tests | ||||||||||
| The Infant/Toddler Checklist (Communication and Symbolic Behavior Scales Developmental Profile) | Parent questionnaire: screens for language delay | 6–24 mo | 24 | 15 min | No | PPV DD: 0.43 (6–8 mo); PPV DD: 0.79 (21–24 mo) | Identifies language delays (alone/with ASD); risk for ASD; risk status for social, speech, symbolic composites, and total score | Available in multiple languages; see test information for details | Paul H. Brookes Publishing Co Inc: 800-638-3775 or www.brookespublishing.com | Ref 59 |
| Early Screening for Autism and Communication Disorders | Parent questionnaire: research edition, 47 items | 12–36 mo | 47 | 10–15 min | No | Sensitivity: 0.85–0.91; specificity: 0.82–0.84; PPV: 0.55–0.81; NPV: 0.88–0.98 | Investigation ongoing of subset (24 items) | English | https://firstwordsproject.com/screen-my-child/ | Not in peer-reviewed literature |
| First-Year Inventory | Parent questionnaire; promising in high-risk population to identify risk in 12-mo-old infants | 12 mo | 63 | 10 min | No | Sensitivity, specificity, PPV not reported | Scores at risk; promising in high-risk (infant sibling) cohort (Rowberry et al575 ) | English | https://www.med.unc.edu/ahs/pearls/research/first-year-inventory-fyi-development/ | Ref 575 |
| Parent’s Observations of Social Interactions | Parent questionnaire used to assess autism risk; ASD screening included on 18-, 24-, and 30-mo The Survey of Well-Being of Young Children: forms | 16–35 mo | 7 | ∼5 min | Available through patient tools, epic, and CHADIS; available for free download as pdfs from www.theswyc.org | Sensitivity: 83%–93%, average 88.5%; specificity: 42%–75%, average 56.9% | 3 of 7 symptoms in at-risk range | Available in multiple languages; see test information for details | Free download from www.theswyc.org | Publications and User’s Manual available at www.theswyc.org; Refs 576 and 577 |
| Rapid Interactive Screening Test for Autism in Toddlers 13 | Clinician observation: administered by trained examiner | 12–36 mo | 9 interactive items | 20–30 min | No | Cutoff >15; sensitivity: 1; specificity: 0.84; PPV: 0.88; NPV: 0.94; needs further study in larger samples | 9 interactive activities; total score summed, cutoff score of 15 (for that sample) | English | https://umassmed.edu/AutismRITA-T/about-the-test/ | Ref 578 |
| Autism Screening Tests . | Description . | Age Range . | Average No. Items . | Administration Time . | Forms Available EHR compatible . | Psychometric Properties . | Scoring Method . | Cultural Considerations . | Source . | Key References . |
|---|---|---|---|---|---|---|---|---|---|---|
| M-CHAT-R/F | Parent-completed questionnaire designed to identify children at risk for autism from the general population; follow-up clinician-administered questions and repeat questionnaire required for specificity | 16–30 mo | 20 | 5–10 min | Yes | Standardization sample included 16 071 children screened; 115 had positive screen results, 348 needed evaluation, 221 were evaluated, and 105 diagnosed with an ASD; validated by using the ADI-R, ADOS-G, CARS, and DSM-IV-TR; sensitivity: 0.91; specificity: 0.95 for low-risk 18- and 24-mo-old children with follow-up questionnaire and interview; 45% of children with a score ≥3 on the initial screen and ≥2 on follow-up had ASD; 95% had clinically significant developmental delay | Risk categorization for questionnaire (pass/need interview/ fail); after interview (pass/fail) | Available in multiple languages; see test information for details | http://mchatscreen.com/ | Ref 51 |
| SCQ | Parent-completed questionnaire; designed to identify children at risk for ASD from the general population; based on items in the ADI-R | 4+ y | 40 | 5–10 min | No | Validated by using the ADI-R and DSM-IV on 200 subjects (160 with pervasive developmental disorder, 40 without pervasive developmental disorder); for use in children with mental age of at least 2 y and chronologic age 4+ y; available in 2 forms: lifetime and current. overall test: sensitivity: 0.85 (moderate), specificity: 0.75 (moderate); sensitivity can be improved with lowering cutoff for children younger than 5 y and 5–7 y, specificity poor for younger children | Risk categorization (pass/fail) | Available in multiple languages; see test information for details. | Western Psychological Corporation: www.wpspublish.com | Refs 77 and 572 |
| STAT | Clinician-directed, interactive, and observation measure; requires training of clinician for standardized administration; not for population screening | 24–35 mo; <24 mo (exploratory) | 12 | 20–30 min | No | Validated by comparison with ADOS-G results in 52 children 24–35 mo (26 with autism, 26 with developmental delay); sensitivity: 0.83, specificity: 0.86, PPV: 0.77, NPV: 0.90, for <24 mo: sensitivity: 0.95, specificity: 0.73, PPV: 0.56, NPV: 0.97; screening properties improved for children >14 mo | 12 activities to observe early social-communicative behavior; risk categorization (high risk/low risk) | English | http://stat.vueinnovations.com/ | Refs 573 and 574 |
| Promising autism screening tests | ||||||||||
| The Infant/Toddler Checklist (Communication and Symbolic Behavior Scales Developmental Profile) | Parent questionnaire: screens for language delay | 6–24 mo | 24 | 15 min | No | PPV DD: 0.43 (6–8 mo); PPV DD: 0.79 (21–24 mo) | Identifies language delays (alone/with ASD); risk for ASD; risk status for social, speech, symbolic composites, and total score | Available in multiple languages; see test information for details | Paul H. Brookes Publishing Co Inc: 800-638-3775 or www.brookespublishing.com | Ref 59 |
| Early Screening for Autism and Communication Disorders | Parent questionnaire: research edition, 47 items | 12–36 mo | 47 | 10–15 min | No | Sensitivity: 0.85–0.91; specificity: 0.82–0.84; PPV: 0.55–0.81; NPV: 0.88–0.98 | Investigation ongoing of subset (24 items) | English | https://firstwordsproject.com/screen-my-child/ | Not in peer-reviewed literature |
| First-Year Inventory | Parent questionnaire; promising in high-risk population to identify risk in 12-mo-old infants | 12 mo | 63 | 10 min | No | Sensitivity, specificity, PPV not reported | Scores at risk; promising in high-risk (infant sibling) cohort (Rowberry et al575 ) | English | https://www.med.unc.edu/ahs/pearls/research/first-year-inventory-fyi-development/ | Ref 575 |
| Parent’s Observations of Social Interactions | Parent questionnaire used to assess autism risk; ASD screening included on 18-, 24-, and 30-mo The Survey of Well-Being of Young Children: forms | 16–35 mo | 7 | ∼5 min | Available through patient tools, epic, and CHADIS; available for free download as pdfs from www.theswyc.org | Sensitivity: 83%–93%, average 88.5%; specificity: 42%–75%, average 56.9% | 3 of 7 symptoms in at-risk range | Available in multiple languages; see test information for details | Free download from www.theswyc.org | Publications and User’s Manual available at www.theswyc.org; Refs 576 and 577 |
| Rapid Interactive Screening Test for Autism in Toddlers 13 | Clinician observation: administered by trained examiner | 12–36 mo | 9 interactive items | 20–30 min | No | Cutoff >15; sensitivity: 1; specificity: 0.84; PPV: 0.88; NPV: 0.94; needs further study in larger samples | 9 interactive activities; total score summed, cutoff score of 15 (for that sample) | English | https://umassmed.edu/AutismRITA-T/about-the-test/ | Ref 578 |
The AAP does not approve/endorse any specific tool for screening purposes. This table is not exhaustive, and other tests may be available. ADOS-G, Autism Diagnostic Observation Schedule – Generic; CARS, Childhood Autism Rating Scale; CHADIS, Comprehensive Health and Decision Information System; EHR, electronic health record; ICD-10, International Classification of Diseases, 10th revision; IMFAR, International Meeting for Autism Research; NPV, negative predictive value; PPV, positive predictive value.