Examining the cross-cultural validity of three early autism screening instruments
McDonough, Jaimi Donald
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Despite evidence to support improved outcomes with early intervention, Autism Spectrum Disorder (ASD) is still being diagnosed, on average, much later than the time at which it can be reliably diagnosed. Research suggests that differences exist between minority racial and SES groups with regard to age at first diagnosis of ASD. Population-wide screening for ASD has been recommended to aid in early identification as well as to reduce disparities in timing of diagnosis, particularly for underserved groups. Although research related to the psychometric properties of ASD assessment instruments is established, little information is available regarding use of ASD assessment instruments with culturally diverse populations. The purpose of the present study was to examine the validity of three early ASD screening instruments across cultural groups to inform clinical use of the instruments with diverse populations. Parent ratings from the Social Communication Questionnaire, Current Version (SCQ-Current), the Modified Checklist for Autism in Toddler (M-CHAT), and the Pervasive Developmental Disorders Screening Test-II (PDDST-II) were collected for 121 children (M age = 3.74 years, SD = 1.14 years) at risk for ASD who were participating in a comprehensive diagnostic evaluation. No significant differences in age at evaluation were found across race or maternal education level. In addition, no significant differences in screener accuracy were observed for minority race groups or for raters without a high school diploma. In contrast, the M-CHAT and M-CHAT Critical Item Total Score differentiated ASD and non-ASD participants more effectively than the SCQ in the total sample. None of the screeners demonstrated acceptable diagnostic accuracy for both sensitivity and specificity within a referred sample. Findings and implications for clinical practice are discussed.