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A new screening programme for autism in a general population of Swedish toddlers

Participants: Gudrun Nygren, Christopher Gillberg & Thomas Arvidsson.

Background: In most countries in the Western world there are developmental child health programmes for children from their first months of life. In Gothenburg, 95-99 % of children are followed up at the Child Health Centres (CHCs) during their first years. Despite regular health check-ups the symptoms of autism have not been noticed, or if noticed, not led to referral for autism diagnostic assessment until several years later. The delay in autism diagnosis was the background for a collaborative project for early detection, diagnosis and early interventions for young children with autism spectrum disorders (ASD). Methods for screening and early detection of autism were introduced as part of the existing developmental surveillance programme at the CHCs. In the study these methods are presented and the psychometric properties for the screening tools are analysed.

Method: The study population consisted of all children coming for their routine 2.5-year-old check-up at the CHCs at any time during 2010 (c. 5000). The screening instruments were also used for other children (regardless of age) raising any suspicion of ASD, and a small subset of the total sample of children younger or older than 24-36 months was also included. The tools used for screening comprised the Modified Checklist for Autism in Children (M-CHAT) + interview and an observation made by trained nurses of the child's joint attention abilities (JA-OBS).

Results: A suspicion of ASD was raised in 64 individuals. 54 of these were clinically assessed in detail. 48 children had a confirmed diagnosis of ASD, three had severe language disorder, and three were classified as having typical development. The Positive Predictive Value (PPV) for the combination of M-CHAT (+ M-CHAT interview) and the JA-OBS was 90%, and the sensitivity 96%. The combination of instruments used showed promise for early detection of autism as a routine in the developmental programme at CHCs and has now been established as a routine in Gothenburg.


Nygren, G., Sandberg, E., Gillstedt, F., Ekeroth, G., Arvidsson, T., & Gillberg, C. (2012). A new screening programme for autism in a general population of Swedish toddlers. Research in Developmental Disabilities, 33, 1200–1210.

Nygren, G., Cederlund, M., Sandberg, E., Gillstedt, F., Arvidsson, T., Carina Gillberg, I., . . . Gillberg, C. (2012). The prevalence of autism spectrum disorders in toddlers: a population study of 2-year-old Swedish children. Journal of Autism and Developmental Disorders, 42, 1491-1497.


Page Manager: Anna Spyrou|Last update: 1/15/2013

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