Screening for Autism Spectrum Disorders in Underserved Populations: Global Versus Specific Surveillance Instruments

Abstract

Objective: The identification of developmental delays during well-child visits is insufficient with clinical judgment alone (30-50%). Method: We analyzed the usefulness of clustering communication and social-personal areas from neurodevelopmental screening ASQ-3 and Denver II PRUNAPE questionnaires, compared with M-CHAT and ADOS as the initial screening for detection of Autism Spectrum Disorders (ASD) at well-child controls at primary-care settings in lowand middle-income countries (LMIC). Results: One hundred children at the Department of Pediatrics from 12 to 66 months (average: 35 months), were assessed by a developmental pediatrician, trained and supervised by ECHO-model. The assessment was completed with a full assessment for autism with a child neurologist, and a child-juvenile psychiatrist. Thirty-one of 100 children arrived at autism spectrum disorder diagnostic criteria. Conclusion: Failure at ASQ-3 communication plus social-personal clusters was in good agreement with M-CHAT to predict risk criteria for autism compared with a full assessment protocol. Clustering Communication and Personal-Social developmental skills from global screeners were sufficient at the pediatric visits, let differential diagnoses with global developmental delay, and communication developmental disorders. These scales covered a wide range of ages for early identification of children with an autism spectrum disorder in primary care settings within an on-site or online format