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Background: The Modified Checklist for Autism in Toddlers (M-CHAT) is a common pediatric screening tool with mixed accuracy findings. Prior evidence supports M-CHAT screening for developmental concerns, especially in toddlers born preterm. This study examined M-CHAT accuracy in a large, nationwide sample., Methods: 3393 participants from the Environmental influences on Child Health Outcomes (ECHO) program were included. Harmonized M-CHAT (M-CHAT-H) results were compared with parent-reported autism diagnosis and autism-related characteristics to assess accuracy for term and preterm children, together and separately. Generalized estimating equations, clustering for ECHO cohort and controlling for demographic covariates, were used to examine associations between developmental and behavioral characteristics with M-CHAT-H accuracy., Results: Sensitivity of the M-CHAT-H ranged from 36 to 60%; specificity ranged from 88 to 99%. Positive M-CHAT-H was associated with more developmental delays and behavior problems. Children with severe motor delays and more autism-related problems were more likely to have a false-negative M-CHAT-H. Children with fewer behavior problems and fewer autism-related concerns were more likely to have a false-positive screen., Conclusion: The M-CHAT-H accurately detects children at low risk for autism and children at increased risk with moderate accuracy. These findings support use of the M-CHAT-H in assessing autism risk and developmental and behavioral concerns in children., Impact: Previous literature regarding accuracy of the Modified Checklist for Autism in Toddlers (M-CHAT) is mixed but this study provides evidence that the M-CHAT performs well in detecting children at low risk for autism and consistently detects children with developmental delays and behavioral problems. The M-CHAT moderately detects children at increased risk for autism and remains a useful screening tool. This study examines M-CHAT accuracy in a large-scale, nationwide sample, examining associations between screening accuracy and developmental outcomes. These findings impact pediatric screening for autism, supporting continued use of the M-CHAT while further elucidating the factors associated with inaccurate screens., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Background: Many children with autism and intellectual disability (ID) experience executive functioning (EF) difficulties. However, there is minimal research on EF skills in children with autism, ID, and co-occurring autism/ID in early childhood., Aims: To address this gap in the research, we evaluated EF profiles using the BRIEF-P among early childhood children (2-5 years of age) with autism, ID, and co-occurring autism/ID., Method and Procedures: Participants in the current study were 87 children between the ages of 24 and 71 months (M = 46.8, SD = 12.7) diagnosed with autism (n = 24, 27.6 %), ID (n = 23, 26.4 %), or co-occurring autism/ID (n = 40, 46.0 %) that completed a comprehensive psychological evaluation at a university development center. We used a mixed Analysis of Variance (ANOVA) and between- and within-subjects ANOVAs as follow-up analyses., Outcomes and Results: Results suggested that early childhood children with autism, ID, and autism/ID may have unique EF skill profiles. Children with ID exhibited the most significant EF impairments and children with autism had the least. Working memory was the most impaired EF domain across all diagnostic groups., Conclusions and Implications: Overall, our findings show that early childhood children with autism, ID, and autism/ID exhibit difficulties in EF skills. Children with ID exhibit the most significant EF impairments whereas children with autism show the least. However, regardless of diagnosis, working memory is the most impaired EF skill., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Lay Abstract: Autistic adults have more health problems then their same-aged peers. Yet little research has been conducted that focuses on addressing these health problems. In order to guide future research, it is important to know what intervention studies have been done to improve health outcomes among autistic adults. The project team and student assistants read studies that were published between 2007 and 2018 in the online research database, PubMed. We looked for studies published in English, which were peer-reviewed and included (1) an intervention, (2) an outcome that was related to health, and (3) a study group that included autistic adults. We did not include studies that had outcomes about employment (unless there was a health outcome), studies about caregivers or caregiving, or expert opinions about interventions. Of 778 reviewed articles, 19 studies met all of the criteria above. Within these studies, two approaches were found to have emerging evidence for their use in autistic adults: cognitive behavioral interventions and mindfulness-based approaches for improved mental health outcomes. The remaining intervention approaches did not have enough articles to support their use. Many of the outcomes were about reduced symptoms of co-occurring mental health diagnoses (e.g. reduced anxiety, depression). Most of the participants in these studies were male and did not have intellectual disability. Most study participants were adults younger than 40. There are not many intervention studies that address health outcomes among autistic adults. More research is needed on interventions which are desired by the adult autism community and address preferred health outcomes such as increased quality of life or well-being.