(Facing camera, clockwise from left) Dr Aishworiya Ramkumar, the study’s senior author, and Dr Ruth Zheng, the study’s co-lead researcher, with Suhaila Nor Osman and her son, who is autistic. - ST
SINGAPORE: 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 months 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 that 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, Chinese-language daily Lianhe Zaobao reported that 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.
“The study was needed to actually see whether it works well in our population before we decide whether we want to use it,” 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 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 that providing early screening in a primary care setting improves its 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.
Said Dr Ramkumar: “Early treatment and intervention can make a big difference to children with autism spectrum disorder as it can lead to better improvements in their skills and development, including improved language and cognitive skills, which in turn can lead to better quality of life, and independent-living skills in future.”
Though she did not go through M-Chat-R/F, Suhaila Nor Osman got early intervention for her son Qaiser Fikri after he was screened for autism, when doctors found that he was still unable to speak at 18 months.
Qaiser, now five, received speech therapy and other forms of intervention, allowing him to better communicate and manage his emotions, the 34-year-old nurse said of her son.
Dr Ramkumar cautioned, however, that while M-Chat-R/F is a useful tool for screening, a positive result from the screening is not equivalent to an autism diagnosis. For that, a definitive assessment is needed, she added. - The Straits Times/ANN
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