Autism screening tests: A narrative review

  • Fatemeh Fekar Gharamaleki
    Department of Speech Therapy, University of Social Welfare and Rehabilitation, Tehran, Iran, Islamic Republic of.
  • Boshra Bahrami
    School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of.
    https://orcid.org/0000-0003-1763-5785
  • Jafar Masumi
    Department of Speech Therapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Science, Tabriz, Iran, Islamic Republic of.
    https://orcid.org/0000-0002-5969-0144

ABSTRACT

As screening tests are tools to quantify communication-interactive abilities of speech and language; therefore, to evaluate, screen, diagnose and treat various aspects of one’s abilities, they are necessary. The purpose of this study is to review the existing autism screening tools, their subtests, administration, scoring, and application in clinical and research contexts in children and adults. This study was a review of autism screening tools; hence, an electronic search through databases such as PubMed, Scopus, Medline, SID, and Magiran was performed from 2000 to 2021. The tests were examined in terms of year of publication, duration, age range, assessment method, subtests, and psychometric properties and furthermore, they were reviewed in details. In this study, 19 autism screening tests were evaluated and The Autism Spectrum Quotient was found to have the shortest administration time while The Gilliam Autism Rating Scale had the longest, and the only test that varied in duration was the Autism Screening Instrument for educational planning. Autism screening is a complex issue. Reviewing these articles reveals that some tests have been used more in recent years due to their specialized subtests or easy and fast administration. Prompt testing is extremely crucial especially in emergency situations like the current COVID-19 pandemic the world is struggling with today. A review of speech tone tests shows that the CARS-2 is one of the most widely validated autism assessments.

REFERENCES

Nuckols CC, Nuckols CC. The diagnostic and statistical manual of mental disorders (DSM-5). Philadelphia: American Psychiatric Association; 2013.

Shiri V, Hosseini SA, Pishyareh E, et al. Studying the relationship of executive functions with behavioral symptoms in children with high-functioning Autism. J Rehabil 2015;16:208-17.

Bahramkhani M, Darvishi N, Keshavarz Z, Dadkhah A. The comparison of executive functions in normal and autistic children, considering mathematics and reading abilities. J Rehabil 2013;13:128-35.

Maenner MJ, Shaw KA, Baio J, et al. Prevalence of autism spectrum disorder among children aged 8 years – autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveillance Summaries 2020;69:1-2. DOI: https://doi.org/10.15585/mmwr.ss6904a1

Slappendel G, Mandy W, van der Ende J, et al. Utility of the 3Di short version for the diagnostic assessment of autism spectrum disorder and compatibility with DSM-5. J Autism Dev Disord 2016;46:1834-46. DOI: https://doi.org/10.1007/s10803-016-2713-9

Wiggins LD, Bakeman R, Adamson LB, Robins DL. The utility of the Social Communication Questionnaire in screening for autism in children referred for early intervention. Focus Autism Devl Dis 2007;22:33-8. DOI: https://doi.org/10.1177/10883576070220010401

Lord C. Follow‐up of two‐year‐olds referred for possible autism. J Child Psychol Psychiatry 1995;36:1365-82. DOI: https://doi.org/10.1111/j.1469-7610.1995.tb01669.x

Charman T, Stone W. Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention. Guilford Press; 2008.

Anagnostou E, Zwaigenbaum L, Szatmari P, et al. Autism spectrum disorder: advances in evidence-based practice. CMAJ 2014;186:509-19. DOI: https://doi.org/10.1503/cmaj.121756

Lord C, Corsello C, Grzadzinski R. Diagnostic instruments in autistic spectrum disorders. In: FR Volkmar, R Paul, SJ Rogers, KA Pelphrey, editors. Handbook of autism and pervasive developmental disorders. Chichester: J. Wiley & Sons; 2014.

Baron-Cohen S, Wheelwright S, Cox A, et al. Early identification of autism by the Checklist for Autism in Toddlers (CHAT). J R Soc Med 2000;93:521-5. DOI: https://doi.org/10.1177/014107680009301007

Stone WL, Coonrod EE, Ousley OY. Brief report: screening tool for autism in two-year-olds (STAT): development and preliminary data. J Autism Dev Disord 2000;30:607. DOI: https://doi.org/10.1023/A:1005647629002

Stone WL, Coonrod EE, Turner LM, Pozdol SL. Psychometric properties of the STAT for early autism screening. J Autism Dev Disord 2004;34:691-701. DOI: https://doi.org/10.1007/s10803-004-5289-8

Goldstein S. Review of the Asperger syndrome diagnostic scale. J Autism Dev Disord 2002;32:611-4. DOI: https://doi.org/10.1023/A:1021215300163

Campbell JM. Diagnostic assessment of Asperger’s disorder: A review of five third-party rating scales. J Autism Dev Disord 2005;35:25-35. DOI: https://doi.org/10.1007/s10803-004-1028-4

Baron-Cohen S, Wheelwright S, Skinner R, et al. The autism-spectrum quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord 2001;31:5-17. DOI: https://doi.org/10.1023/A:1005653411471

Hoekstra RA, Bartels M, Cath DC, Boomsma DI. Factor structure, reliability and criterion validity of the Autism-Spectrum Quotient (AQ): a study in Dutch population and patient groups. J Autism Dev Disord 2008;38:1555-66. DOI: https://doi.org/10.1007/s10803-008-0538-x

Robins DL, Fein D, Barton ML, Green JA. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord 2001;31:131-44. DOI: https://doi.org/10.1037/t03999-000

Inada N, Koyama T, Inokuchi E, et al. Reliability and validity of the Japanese version of the Modified Checklist for autism in toddlers (M-CHAT). Res Autism Spect Dis 2011;5:330-6. DOI: https://doi.org/10.1016/j.rasd.2010.04.016

Snow AV, Lecavalier L. Sensitivity and specificity of the Modified Checklist for Autism in Toddlers and the Social Communication Questionnaire in preschoolers suspected of having pervasive developmental disorders. Autism 2008;12:627-44. DOI: https://doi.org/10.1177/1362361308097116

Witwer AN, Lecavalier L. Autism screening tools: an evaluation of the social communication questionnaire and the developmental behaviour checklist–autism screening algorithm. J Intellect Dev Disabil 2007;32:179-87. DOI: https://doi.org/10.1080/13668250701604776

Soleimani F, Khakshour A, Abbasi Z, et al. Review of autism screening tests. International J Pediatrics 2014;2:319-29.

Williams JG, Allison C, Scott FJ, et al. The childhood autism spectrum test (CAST): Sex differences. J Autism Dev Disord 2008;38:1731. DOI: https://doi.org/10.1007/s10803-008-0558-6

Gilliam JE. Gilliam Asperger's Disorder Scale: GADS. Austin: Pro-Ed.; 2001.

Stehouwer JD. Test Review: Rick, JR (2003). Krug Asperger's Disorder Index (KADI). Austin, TX: PRO-ED. Assess Effect Interv 2005;31:85-8. DOI: https://doi.org/10.1177/073724770503100109

Baird G, Charman T, Cox A, et al. Screening and surveillance for autism and pervasive developmental disorders. Arch Dis Childhood 2001;84:468-75. DOI: https://doi.org/10.1136/adc.84.6.468

Siegel B. PDDST-II, pervasive developmental disorders screening test-II: Early childhood screener for autistic spectrum disorders. Harcourt Assessment; 2004. DOI: https://doi.org/10.1037/t15134-000

Gray KM, Tonge BJ, Sweeney DJ, Einfeld SL. Screening for autism in young children with developmental delay: an evaluation of the developmental behaviour checklist: early screen. J Autism Dev Disord 2008;38:1003-10. DOI: https://doi.org/10.1007/s10803-007-0473-2

Constantino JN, Gruber CP. Social responsiveness scale: SRS-2. Torrance: Western Psychological Services; 2012.

Bölte S, Poustka F, Constantino JN. Assessing autistic traits: cross‐cultural validation of the social responsiveness scale (SRS). Autism Res 2008;1:354-63. DOI: https://doi.org/10.1002/aur.49

Dietz C, Swinkels S, van Daalen E, ry sl. Screening for autistic spectrum disorder in children aged 14–15 months. II: Population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings. J Autism Dev Disord 2006;36:713-22. DOI: https://doi.org/10.1007/s10803-006-0114-1

Lecavalier L. An evaluation of the Gilliam autism rating scale. J Autism Dev Disord 2005;35:795-805. DOI: https://doi.org/10.1007/s10803-005-0025-6

Li N. Preliminary validation of the Childhood Autism Rating Scale-questionnaire for parents or caregivers (CARS2-QPC) and the Gilliam Autism Rating Scale (GARS-2) with a Chinese-speaking population. PhD Theses, Eastern Kentucky University.

Volkmar FR, Cicchetti DV, Dykens E, et al. An evaluation of the autism behavior checklist. J Autism Dev Disord 1988;18:81-97. DOI: https://doi.org/10.1007/BF02211820

Eaves RC, Campbell HA, Chambers D. Criterion‐related and construct validity of the pervasive developmental disorders rating scale and the autism behavior checklist. Psychol Schools 2000;37:311-21. DOI: https://doi.org/10.1002/1520-6807(200007)37:4<323::AID-PITS2>3.0.CO;2-S

Eaves RC, Williams TO Jr. The reliability and construct validity of ratings for the Autism Behavior Checklist. Psychol Schools 2006;43:129-42. DOI: https://doi.org/10.1002/pits.20122

Frye VH, Walker KC. Book review: Autism screening instrument for educational planning, (ASIEP-2). J Psychoeduc Assess 1998;16:280-5. DOI: https://doi.org/10.1177/073428299801600311

Krug DA, Arick JR, Almond PJ. Autism screening instrument for educational planning: Examiner's manual. Austin: Pro-Ed; 1993.

Krug DA, Arick JR, Almond P. Autism screening instrument for educational planning. Austin: Pro-ed; 2008.

Chlebowski C, Green JA, Barton ML, Fein D. Using the childhood autism rating scale to diagnose autism spectrum disorders. J Autism Dev Disord 2010;40:787-99. DOI: https://doi.org/10.1007/s10803-009-0926-x

Garfin DG, McCallon D. Validity and reliability of the Childhood Autism Rating Scale with autistic adolescents. J Autism Dev Disord 1988;18:367-78. DOI: https://doi.org/10.1007/BF02212193

Perry A, Condillac RA, Freeman NL, et al. Multi-site study of the Childhood Autism Rating Scale (CARS) in five clinical groups of young children J Autism Dev Disord 2005;35:625-34. DOI: https://doi.org/10.1007/s10803-005-0006-9

Allison C, Baron-Cohen S, Wheelwright S, et al. The Q-CHAT (Quantitative CHecklist for Autism in Toddlers): a normally distributed quantitative measure of autistic traits at 18–24 months of age: preliminary report. J Autism Dev Disord 2008;38:1414-25. DOI: https://doi.org/10.1007/s10803-007-0509-7

Allison C, Auyeung B, Baron-Cohen S. Toward brief “red flags” for autism screening: the short autism spectrum quotient and the short quantitative checklist in 1,000 cases and 3,000 controls. J Am Acad Child Adolesc Psychiatry 2012;51:202-12. DOI: https://doi.org/10.1016/j.jaac.2011.11.003

Lundin A, Kosidou K, Dalman C. Measuring autism traits in the adult general population with the brief autism-spectrum quotient, AQ-10: Findings from the Stockholm public health cohort. J Autism Dev Disord 2019;49:773-80. DOI: https://doi.org/10.1007/s10803-018-3749-9

Samadi SA, McConkey R. Screening for autism in Iranian preschoolers: Contrasting M-CHAT and a scale developed in Iran. J Autism Dev Disord 2015;45:2908-16. DOI: https://doi.org/10.1007/s10803-015-2454-1

Bahrami B, Fekar-Gharamaleki F. The pragmatic assessments in children: A narrative review. J Res Rehabil Sci 2021.

Ghorbani E, Seyedeyn S, Safarian N, et al. Autism screening and diagnosis tests: A review article. J Mazandaran Univ Med Sci 2013;23:118-33.