Screening for Autism in 2-Year-Old Children: The Application of the Systematic Observation of Red Flags to the Screening Tool for Autism in Toddlers and Young Children

Tara Rooney, Yael S. Stern, Lauren H. Hampton, Jeffrey Grauzer, Amanda Hobson, Amy Levin, Maranda K. Jones, Aaron J. Kaat, Megan Y. Roberts*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: A multimeasure approach was developed to capitalize on the strengths of two screening measures: the Screening Tool for Autism in Toddlers and Young Children (STAT), an observational measure of social communication, and the Systematic Observation of Red Flags (SORF), a checklist including restricted and repetitive behavior (RRB) items. This approach offers a novel method of identifying autism in toddlers. Method: This was a retrospective study of data collected from a multidisciplin-ary diagnostic program for 24-to 36-month-olds with developmental delays. Raters with autism expertise but naïve to diagnoses applied the SORF to STAT videos. Psychometrics were derived for the SORF on STAT observations and a multiple-measure approach that used a Least Absolute Shrinkage and Selection Operator modeling framework to construct a STAT-SORF RRB Hybrid, retaining SORF RRB items based on individual predictive abilities. Results: The SORF alone correctly classified 84% of the sample (84% sensitivity and 86% specificity). The STAT-SORF RRB Hybrid model, which retained four SORF RRB items, correctly classified 90% of a validation sample (95% sensitivity and 75% specificity). Conclusion: These findings highlight the potential utility of using multiple autism identification tools and regression-based scoring to establish presumptive eligi-bility and facilitate early access to autism interventions.

Original languageEnglish (US)
Pages (from-to)2759-2769
Number of pages11
JournalAmerican journal of speech-language pathology
Volume31
Issue number6
DOIs
StatePublished - Nov 2022

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Speech and Hearing
  • Otorhinolaryngology
  • Linguistics and Language

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