A new study has shown the effectiveness of a screening tool in early detection of autism in primary care settings, allowing for earlier interventions for young children with the condition.
The large-scale study, which was conducted between August 2020 and November 2022, involved 5,336 children between the ages of 17 and 20 months.
It examined the efficacy of a questionnaire called the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-Chat-R/F).
M-Chat-R/F, which consists of a series of 20 questions, asks parents whether their child can perform simple actions such as pointing to objects with one finger, or if he tries to copy a parent’s actions.
Usually detected in early childhood, autism is a neuro-developmental condition which can affect learning and development in children.
The study – led by the Child Development Unit of the National University Hospital’s Khoo Teck Puat-National University Children’s Medical Institute (KTP-NUCMI) – was conducted at the seven polyclinics under the National University Polyclinics (NUP).
It found that 113 participants, or about 2 per cent of the cohort, screened positive for autism. Of these, 85.7 per cent were confirmed to have autism following further evaluation at the Child Development Unit.
The study’s findings were published in the peer-reviewed academic journal Autism in October 2023.
While M-Chat-R/F is commonly used to screen for autism in other countries, it is not as commonly used here.
In 2017, the Lazarus Centre, which provides therapy for children with autism and dyslexia here, began offering an online M-Chat-R/F tool to help parents screen for autism in their children, said Dr Aishworiya Ramkumar, a consultant with KTP-NUCMI’s Child Development Unit.
M-Chat-R/F is currently offered by all seven NUP polyclinics, including the Jurong and Queenstown polyclinics, as part of the routine 18-month childhood development screening.
During a briefing on March 14, Dr Ramkumar, who is the study’s senior author, told reporters that further studies on the questionnaire are needed to better understand issues such as the most appropriate age to screen for autism.
NUP senior consultant family physician Ruth Zheng, the study’s co-lead researcher, noted providing early screening in a primary care setting improves accessibility to families.
The children in the study received a comprehensive evaluation at the average age of 21.9 months, and began therapy at an average of 22.1 months.
In comparison, an earlier study looking at autism trends in Singapore between 2016 and 2018, also led by Dr Ramkumar, found that the average age of autism diagnosis was about 35.5 months, while the average age for receiving intervention was 42 months.
