• Nina Stenberg, Michaeline Bresnahan, Nina Gunnes, Deborah Hirtz, Mady Hornig, Kari Kveim Lie, W Ian Lipkin, Catherine Lord, Per Magnus, Ted Reichborn-Kjennerud, Synnve Schjølberg, Pål Surén, Ezra Susser, Britt Kveim Svendsen, Stephen von Tetzchner, Anne-Siri Oyen, and Camilla Stoltenberg.
• Norwegian Institute of Public Health, Oslo, Norway.
• Paediatr Perinat Epidemiol. 2014 May 1;28(3):255-62.

BackgroundPrevious research on clinical and high-risk samples suggests that signs of autism spectrum disorder (ASD) can be detected between 1 and 2 years of age. We investigated signs of ASD at 18 months in a population-based sample and the association with later ASD diagnosis.MethodsThe study sample includes 52,026 children born 2003 through 2008 and is a subset of children that participated in the Norwegian Mother and Child Cohort (MoBa), a population-based longitudinal study, and the Autism Birth Cohort (ABC), a sub-study on ASD. Parents completed all 23 items from the Modified Checklist for Autism in Toddlers (M-CHAT) at 18 months.ResultsThe M-CHAT 6-critical-item criterion and the 23-item criterion had a specificity of 97.9% and 92.7% and a sensitivity of 20.8% and 34.1%, respectively. In the 173 children diagnosed with ASD to date, 60 children (34.7%) scored above the cut-off on either of the screening criteria. The items with the highest likelihood ratios were 'interest in other children', 'show objects to others' and 'response to name'.ConclusionEven though one-third of the children who later received an ASD diagnosis were identified through M-CHAT items, the majority scored below cut-off on the screening criteria at 18 months. The results imply that it might not be possible to detect all children with ASD at this age.© 2014 John Wiley & Sons Ltd.

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