Identifying Autism Spectrum Disorder in Real-World Health Care Settings
diagnosis for autism spectrum disorder
(ASD) and ameliorate disparities in the
identification of children with ASD from
diverse backgrounds, we have only
recently begun to move the needle.1,2
We acknowledge the formidable task
pediatricians face in recognizing ASD,
a condition with relatively low
prevalence and signs that may not be
apparent during a brief clinical
encounter.3 Despite its promise for
aiding pediatricians and improving ASD
identification, emerging research
suggests that the Modified Checklist for
Autism in Toddlers (M-CHAT) is less
accurate in detecting ASD in clinical
practice than previously thought. In this
issue of Pediatrics, Carbone et al4
performed a retrospective study using
electronic health record data to
evaluate screening practices and ASD
diagnostic outcomes for children aged
16 to 30 months seen between 2013
and 2016 in one large health system in
Utah. This important work closely
parallels a similar study published by
our research group in Pediatrics in
2019.5 We applaud the editors for
publishing 2 articles with such similar
methods and findings, because
replication is particularly critical when
findings are in contrast to previous
results and suggest the need to
reconsider current clinical practice.