Study Shows that New Screening Tool for Autism in Children can Lead to Earlier Intervention

Autism Spectrum Disorder (ASD) has over time, become more apparent in society. This can be attributed to the decreasing stigma around it and the rising awareness of its signs, and as more people realise that they exhibit signs, more people are getting diagnosed.

However despite this improvement, stigma and hatred around autism ultimately still run deep, with harmful jokes about it being made especially on TikTok.

@thatsjustchris #stitch with @Luke Jones ♬ original sound – Chris Carter

Therefore, I think more can be done to include our autistic friends in the community and that starts with an accurate and effective diagnosis.

What is Autism?

For those who need a refresher, HealthHub SG describes people with ASD as someone who has a neuro-developmental condition that affects socialisation and has “restricted or repetitive patterns of behaviours and interest”.

Some of the symptoms include:

• Having difficulty maintaining or making eye contact
• Having trouble with expression and empathy
• Tending to repeat certain behaviours in the same manner
• Having an unusual way of playing or no play
• Having difficulties with changes in schedule or routine
• Being more likely to experience anxiety, learning disabilities and eating problems.

New and Improved Screening Tool

The Child Development Unit of the National University Hospital’s Khoo Teck Puat-National University Children’s Medical Institute (KTP-NUCMI) led a large-scale study on autism detection.

It was conducted at seven polyclinics under the National University Polyclinics across two years (Aug 2020 to Nov 2022), and it included 5,336 children between ages 17 months to 20 months. (or between 1 to 2 years old)

The research study aimed to review the efficiency of an autism-detecting questionnaire called the: Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-Chat-R/F).

Parents of autism-suspected children typically fill out the 20-question form seen below.

This study was important for early intervention here, as the questionnaire isn’t commonly used here compared to other countries.

In fact, we have been relying on the Autism Diagnosis Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS). ADI-R has a specificity of about 82 per cent and a sensitivity of 75 per cent.

Promising Results

During their study, about 2 per cent out of the 113 participants screened positive for autism using the questionnaire. When they went for follow-up at the Child Development Unit to confirm their diagnosis, 85.7 per cent of them were accurately diagnosed.

That means that the effectiveness of the tool is around 90 per cent.

This was considered a notable finding and was eventually published in the credible academic journal Autism in Oct 2023.

Dr Aishworya Ramkumar, a consultant with KTP-NUCMI’s Child Development Unit, said that doing this study was “needed to actually see whether it works well in our population before we decide whether we want to use it.”

Now, the M-Chat-R/F questionnaire is offered at all NUP polyclinics as part of the screening routine where parents bring their 18-month-old child for a development check-up.

Moving Forward

Dr Ramkumar emphasised that “early treatment and intervention can make a big difference to children with autism spectrum disorder”.

That means that better improvements in their social, developmental and cognitive skills can happen. From there, our autistic friends can lead a more independent and fulfilling life like the rest of us.

What can we do? 

Like with any other person, remember to exercise kindness, be patient and stay positive when meeting or talking to persons with autism.