Background
Methods
Eligibility criteria
Information sources
Search ID# | Search terms | Results |
---|---|---|
S18 | S16 AND S17 | (36) |
S17 | nurs* or allied health or health care provider | (138,950) |
S16 | S14 AND S15 | (886) |
S15 | cultur* | (295,498) |
S14 | S7 AND S13 | (25,630) |
S13 | S8 OR S9 OR S10 OR S11 OR S12 | (1,257,837) |
S12 | assess* | (628,678) |
S11 | detect* | (110,318) |
S10 | test* | (740,387) |
S9 | surveillance | (0) |
S8 | screen* | (76,978) |
S7 | S1 OR S2 OR S3 OR S4 OR S5 OR S6 | (70,399) |
S6 | rett* | (1752) |
S5 | kanner* | (810) |
S4 | pervasive* | (14,573) |
S3 | asperger* | (3496) |
S2 | ASD spectrum disorders | (32,945) |
S1 | autis* | (62,874) |
Study selection
Extracted data
Author | Study design | Place | Participants | Informants | Screening tool |
---|---|---|---|---|---|
1. Albores-Gallo et al. [50] | Case control | Mexico Clinical/Psychiatric unit Community/Nurseries | N = 456 18–72 months Mean age = 4.46 years | Parents | The Mexican Modified Checklist for Autism in Toddlers (MM-CHAT) Detect nonverbal children with low function autism |
2. Ben-Sasson and Carter [13] | Cohort | Israel Day care | N = 471 Age M = 12.7 months | Mainly mothers | The First Year Inventory (FYI) |
3. Beuker et al. [51] | Cross sectional | Norway Hospital | N = 12,984 18 months Mean age: 18.53 months | Mothers | The Norwegian Modified Checklist for Autism in Toddlers (M-CHAT) Norwegian Early Screening of Autistic Traits (ESAT) |
4. Canal-Bedia et al. [53] | Stage 1: Case control | Spain Extended Health Centre & Psychiatric | N-2480 18–36 months | Parents | The Spanish Modified Checklist for Autism in Toddlers (M-CHAT) + M-Chat Phone interview |
Stage 2: Cross sectional | N-2055 18–36 months | ||||
5. Carakovac et al. [56] | Case control | Serbian Primary Healthcare & Psychiatric | N = 148 Mean age = 22.25–23.53 months | Parents | The Serbian Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) |
6. Fombonne et al. [49] | Case control | Mexico Autism Developmental Disorder Clinic Public primary school | N = 563 4–13 years Mean age: 8 years | Parents and teachers | Spanish version of the Social Responsiveness Scale (SRS) |
7. Kamio et al. [46] | Cohort | Japan Routine check-up local Health Centre | N = 2516 18 months–3 years Mean age: 18.6–19.2 | Parents | The Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT JV) |
8. Kamio et al. [47] | Cohort | Japan Routine check-up local Health Centre | N = 1851 18 months–3 years Mean age: 18.7 months | Parents + trained interviewers | The Japanese verson of the Modified Checklist for Autism in Toddlers (M-CHAT JV) + Follow up Interview (FI) |
9. Kara et al. [57] | Cross sectional | Turkey Well-child Paediatric | N = 191 18–36 months Mean age: 27.15 | Parents | The Turkish version of the Modified Checklist for Autism in Toddlers (M-CHAT) + FI |
10. Kara et al. [57] | Case control | Turkey Well child Paediatric Psychiatric-autism centre | N = 618 18–36 months Mean age: 27.15 | Nurses and psychologists | The Turkish version of the Modified Checklist for Autism in Toddlers (M-CHAT) |
11. Kondolot et al. [55] | Cross sectional | Turkey Family Health Centres | N = 4000 18–30 months Mean age: 23–24 months | Trained interviewers | The Turkish version of the Modified Checklist for Autism in Toddlers (M-CHAT) |
12. Mohamed et al. [43] | Cross sectional | Egypt Primary Health Centres | N = 5546 1–2.9 years Mean age: 1.7 | Parents | An Arabic validated version of Modified Checklist for Autism in Toddlers (M-CHAT) |
13. Mohammadian et al. [45] | Case control | Iran Hospital nursery Psychiatric Hospital Autism Centre | N = 100 Mean age: 27.1 29.62 months | Mothers | The Iranian version of the Quantitative Checklist for or Autism in Toddlers (Q-CHAT) |
14. Nygren et al. [54] | Cohort | Sweden Child Health Centre 2.5 year check-up | N = 3999 Mean age: 1.5 years | Mothers + trained nurses | The Sweden version of the Modified Checklist for Autism in Toddlers (M-CHAT) +FI + Joint Attention Observation (JA-OBS) |
15. Perera et al. [53] | Cross sectional | Sri Lanka Primary Health Centre | N = 374 18–24 months | Mothers | Red Flag criteria + the Modified Checklist for Autism in Toddlers (M-CHAT) |
16. Perera et al. [19] | Case control | Sri Lanka Paediatric Hospital | N = 105 18–48 months Mean age: 36–40 months | Mothers | The Pictorial Autism Assessment Schedule (PAAS) |
17. Samadi and McConkey [7] | Cohort | Iran Population based Kindergarten and Pre-school Centres | N = 2941 2–5 years | Parents | Hiva + follow-up interview (FI) + the Modified Checklist for Autism in Toddlers (M-CHAT) |
18. Seif Eldin et al. [42] | Case control | 9 Arab countries Not reported | N = 228 18–36 months | Parents | The Modified Checklist for Autism in Toddlers (M-CHAT) |
19. Seung et al. [48] | Cohort | Korea Day care, public HC, Hospitals, paediatric clinic | N = 2300 16–36 months | Parents + first author for FI | The Korean Modified Checklist for Autism in Toddlers (K-M-CHAT)-2 + Phone FI |
20. Wong et al. [44] | Case control | Hong Kong Maternal and child Health clinics Psychiatric | N = 212 13–86 months | Parents + trained investigator | Checklist for Autism in Toddlers (CHAT-23) |
The ecological validity framework | |
---|---|
1. Language: Does the study report the use of a culturally appropriate language, idioms, regionalism words, and slang in both written and verbal forms while adopting/screening for autism? | |
2. Persons: Does the study highlight ethnic and interactional match considerations between the clients and assessors in the screening process? | |
3. Metaphors: Does the study employ any verbal (e.g., folk sayings) and/or visual forms (e.g., image, figure) of symbols that are shared with the population, while adopting instruments/screening for autism? | |
4. Contents: Does the study consider adapting the instruments’ content to match the uniqueness culture of the study group? | |
1. Concepts: Does the study present any efforts to adapt clear and consistent constructs to the targeted culture? | |
2. Goals: Are the screening goals constructed within the context of cultural values, customs, and traditions? | |
3. Methods: Do the study methods facilitate smooth implementation for screening within the client’s cultural context? | |
4. Context: Does the study consider the social, economic, historical, and political contexts of clients while screening? |
Author | Language | Persons | Metaphors | Content | Concepts | Goals | Methods | Context |
---|---|---|---|---|---|---|---|---|
Albores-Gallo et al. [50] | + | – | – | – | + | – | – | – |
Ben-Sasson and Carter [13] | + | + | – | – | + | – | – | – |
Beuker et al. [51] | + | – | – | – | – | – | – | – |
Canal-Bedia et al. [53] | + | – | + | + | + | – | – | |
Carakovac et al. [56] | + | – | – | – | + | – | – | – |
Fombonne et al. [49] | + | – | – | – | – | – | – | – |
Kamio et al. [46] | + | – | – | – | – | – | ||
Kamio et al. [47] | + | – | – | – | + | – | – | – |
Kara et al. [57] | + | – | – | – | – | + | + | |
Kondolot et al. [55] | + | – | + | + | + | |||
Mohamed et al. [43] | + | – | – | – | – | – | – | – |
Mohammadian et al. [45] | + | – | – | – | – | – | – | – |
Nygren et al. [54] | + | – | – | – | + | – | + | – |
Perera et al. [53] | + | – | – | – | – | – | + | – |
Perera et al. [19] | + | + | + | – | + | – | – | – |
Samadi and McConkey [7] | + | – | – | – | + | – | – | – |
Seif Eldin et al. [42] | + | – | – | – | – | – | – | + |
Seung et al. [48] | + | – | – | – | + | – | – | – |
Wong et al. [44] | + | – | – | + | – | – | + | – |
The feasibility of screening | |
---|---|
1. Acceptability: Do study’s participants perceive an appropriateness or suitability for screening for ASD within the intended culture and context? | |
2. Demand: Do study’s participants express a need and/or intention to use the screening instrument within current practice? | |
3. Implementation: Was the screening process implemented as proposed? | |
4. Practicality: Does the study report the cost, time and other resources required to screen for ASD? | |
5. Adaptation: Does the study adapt the screening instrument for the intended population culture? | |
6. Integration: Does the study highlight the possibility of integrating the screening instrument within the existing system? | |
7. Expansion: Does the study perceive any opportunity to expand the use of screening within a different population in a different setting? | |
8. Limited efficacy: Does the study report limited efficacy of the screening and/or its instruments? |
Author | Acceptability | Demand | Implementation | Practicality | Adaptation | Integration | Expansion | Limited efficacy |
---|---|---|---|---|---|---|---|---|
Albores-Gallo et al. [50] | – | – | + | + | + | + | + | + |
Ben-Sasson and Carter [13] | – | – | + | – | + | + | + | + |
Beuker et al. [51] | – | – | + | + | + | – | + | + |
Canal-Bedia et al. [53] | + | – | + | + | + | + | – | + |
Carakovac et al. [56] | – | – | + | + | + | + | – | – |
Fombonne et al. [49] | – | – | + | + | + | – | + | + |
Kamio et al. [46] | – | – | + | + | + | + | + | + |
Kamio et al. [47] | – | – | + | + | + | + | – | – |
Kara et al. [57] | – | – | + | + | + | – | – | + |
Kondolot et al. [55] | – | – | + | + | + | + | – | – |
Mohamed et al. [43] | – | – | + | + | + | – | – | – |
Mohammadian et al. [45] | – | – | + | – | + | – | – | – |
Nygren et al. [54] | – | + | + | + | + | + | – | + |
Perera et al. [53] | – | – | + | – | + | + | – | – |
Perera et al. [19] | – | – | + | + | + | + | – | – |
Samadi and McConkey [7] | – | – | + | + | + | + | – | + |
Seif Eldin et al. [42] | – | – | + | + | + | + | + | – |
Seung et al. [48] | – | – | + | + | + | – | + | + |
Wong et al. [44] | – | – | + | + | + | + | + | + |
Quality assessments
Authors | Albores-Gallo et al. [50] | Ben-Sasson and Carter [13] | Beuker et al. [51] | Canal-Bedia et al. [53] | Carakovac et al. [56] | Fombonne et al. [49] | Kamio et al. [47] | Kamio et al. [46] | Kara et al. [57] | Kondolot et al. [55] |
---|---|---|---|---|---|---|---|---|---|---|
Quality assessment criteria | ||||||||||
1. Question/objective sufficiently described | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
2. Study design evident and appropriate | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
3. Method of subject/comparison group selection or source of information/input variables described and appropriate | 2 | 2 | 2 | 2 | 1 | 2 | 2 | 2 | 2 | 2 |
4. Subject (and comparison group, if applicable) characteristics sufficiently described | 2 | 2 | 2 | 1 | 1 | 1 | 1 | 1 | 1 | 2 |
5. If interventional and random allocation was possible, was it described? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
6. If interventional and blinding of investigators was possible, was it reported? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
7. If interventional and blinding of subjects was possible, was it reported? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
8. Outcome and (if applicable) exposure measure(s) well defined and robust to any measurement/misclassification bias. Means of assessment reported | 2 | 2 | 2 | 2 | 2 | 1 | 2 | 2 | 2 | 2 |
9. Sample size appropriate | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 1 | 2 | 2 |
10. Analytical methods described/justified and appropriate | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 1 | 1 |
11. Some estimate of variance is reported for the main results | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
12. Controlled for confounding | 2 | N/A | N/A | N/A | 1 | 2 | N/A | N/A | N/A | N/A |
13. Results reported in sufficient detail | 2 | 2 | 2 | 2 | 1 | 1 | 2 | 2 | 2 | 2 |
Total sum = (number of “yes” *2) + (number of “partials” * 1) | 18 | 16 | 16 | 16 | 14 | 15 | 15 | 15 | 15 | 16 |
Total possible sum = 28 − (number of “N/A” * 2) | 22 | 20 | 20 | 20 | 22 | 22 | 20 | 20 | 20 | 20 |
Summary score: total sum/total possible sum | 0.82 | 0.80 | 0.80 | 0.80 | 0.64 | 0.68 | 0.75 | 0.75 | 0.75 | 0.80 |
Authors | Mohammed (2012) | Mohammadian et al. [45] | Nygren et al. [54] | Perera et al. [53] | Perera et al. [19] | Samadi and McConkey [7] | Seif Eldin et al. [42] | Seung et al. [48] | Wong et al. [44] |
---|---|---|---|---|---|---|---|---|---|
Quality assessment criteria | |||||||||
1. Question/objective sufficiently described | 2 | 2 | 2 | 1 | 2 | 2 | 2 | 2 | 2 |
2. Study design evident and appropriate | 2 | 2 | 2 | 2 | 2 | 1 | 2 | 2 | 2 |
3. Method of subject/comparison group selection or source of information/input variables described and appropriate | 2 | 1 | 2 | 1 | 2 | 1 | 1 | 2 | 2 |
4. Subject (and comparison group, if applicable) characteristics sufficiently described | 2 | 2 | 2 | 1 | 2 | 2 | 1 | 2 | 2 |
5. If interventional and random allocation was possible, was it described? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
6. If interventional and blinding of investigators was possible, was it reported? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
7. If interventional and blinding of subjects was possible, was it reported? | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
8. Outcome and (if applicable) exposure measure(s) well defined and robust to any measurement/misclassification bias. Means of assessment reported | 2 | 2 | 2 | 1 | 2 | 2 | 0 | 2 | 2 |
9. Sample size appropriate | 2 | 1 | 2 | 1 | 1 | 1 | 1 | 1 | 2 |
10. Analytical methods described/justified and appropriate | 1 | 2 | 2 | 1 | 1 | 2 | 2 | 1 | 2 |
11. Some estimate of variance is reported for the main results | 2 | 2 | 2 | 1 | 2 | 2 | 1 | 2 | 1 |
12. Controlled for confounding | N/A | N/A | N/A | N/A | 1 | N/A | 2 | N/A | 2 |
13. Results reported in sufficient detail | 2 | 2 | 2 | 1 | 2 | 2 | 2 | 2 | 2 |
Total sum = (number of “yes” *2) + (number of “partials” * 1) | 17 | 16 | 18 | 12 | 17 | 15 | 14 | 16 | 19 |
Total possible sum = 28 − (number of “N/A” * 2) | 22 | 20 | 20 | 20 | 22 | 20 | 22 | 20 | 22 |
Summary score: total sum/total possible sum | 0.77 | 0.80 | 0.90 | 0.60 | 0.77 | 0.75 | 0.64 | 0.80 | 0.86 |