Abstract：
OBJECTIVE: Early detection and intervention are associated with improved outcomes for autistic children. Thus, it is important to understand factors influencing early screening tools designed to detect autism. This study examined the relationship between caregiver-reported emotional and behavioral symptoms and children\'s scores on a commonly used autism screening questionnaire, the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F).
METHODS: Toddlers were recruited from four primary care clinics between 2018 and 2021. Their caregivers completed the M-CHAT-R/F as well as the Child Behavior Checklist (CBCL), a well-validated, normed measure of emotional and behavioral functioning. Correlational and group analyses were evaluated to examine relationships between CBCL scales and M-CHAT-R/F scores.
RESULTS: 1765 toddlers were recruited for the study. CBCL scores for the internalizing, externalizing, autism, ADHD, and anxiety scales were all modestly positively correlated with M-CHAT-R/F scores. Compared to toddlers with elevated autism scale scores only, toddlers with elevations in both autism and ADHD/externalizing scales had higher M-CHAT-R/F scores. In contrast, no significant difference in scores were found between toddlers with elevated autism scale scores only compared to those with elevated scores on both autism and internalizing scales.
CONCLUSIONS: Findings suggest that, for children with elevated autism behaviors, the presence of externalizing symptoms, including ADHD-related concerns, is associated with elevated scores on the M-CHAT-R/F. In contrast, internalizing symptoms did not show an association with elevated M-CHAT-R/F scores among toddlers with elevated autism-related behaviors. Interpretation of the M-CHAT-R/F should include consideration of co-occurring psychiatric conditions, especially externalizing conditions such as ADHD.
METHODS: Toddlers were recruited from four primary care clinics between 2018 and 2021. Their caregivers completed the M-CHAT-R/F as well as the Child Behavior Checklist (CBCL), a well-validated, normed measure of emotional and behavioral functioning. Correlational and group analyses were evaluated to examine relationships between CBCL scales and M-CHAT-R/F scores.
RESULTS: 1765 toddlers were recruited for the study. CBCL scores for the internalizing, externalizing, autism, ADHD, and anxiety scales were all modestly positively correlated with M-CHAT-R/F scores. Compared to toddlers with elevated autism scale scores only, toddlers with elevations in both autism and ADHD/externalizing scales had higher M-CHAT-R/F scores. In contrast, no significant difference in scores were found between toddlers with elevated autism scale scores only compared to those with elevated scores on both autism and internalizing scales.
CONCLUSIONS: Findings suggest that, for children with elevated autism behaviors, the presence of externalizing symptoms, including ADHD-related concerns, is associated with elevated scores on the M-CHAT-R/F. In contrast, internalizing symptoms did not show an association with elevated M-CHAT-R/F scores among toddlers with elevated autism-related behaviors. Interpretation of the M-CHAT-R/F should include consideration of co-occurring psychiatric conditions, especially externalizing conditions such as ADHD.
摘要：
目的：早期发现和干预有助于改善自闭症儿童的预后。因此，重要的是要了解影响早期筛查工具，旨在检测自闭症的因素。这项研究检查了照顾者报告的情绪和行为症状与儿童在常用自闭症筛查问卷上的得分之间的关系。修改后的幼儿自闭症检查表-随访修订（M-CHAT-R/F）。
方法：在2018年至2021年期间，从四家初级保健诊所招募了幼儿。他们的照顾者完成了M-CHAT-R/F以及儿童行为清单（CBCL），一个经过充分验证的，情绪和行为功能的规范测量。评估相关性和分组分析以检查CBCL量表与M-CHAT-R/F评分之间的关系。
结果：招募了1765名幼儿进行研究。内化的CBCL分数，外部化，自闭症,多动症,焦虑量表与M-CHAT-R/F评分均呈适度正相关。与仅自闭症量表得分较高的幼儿相比，自闭症和ADHD/外化量表均升高的幼儿的M-CHAT-R/F得分较高。相比之下,仅与自闭症和内化量表得分均较高的幼儿相比，自闭症量表得分较高的幼儿之间的得分没有显着差异。
结论：研究结果表明，对于自闭症行为升高的儿童，外化症状的存在，包括多动症相关的问题，与M-CHAT-R/F上的分数升高相关。相比之下,在自闭症相关行为升高的幼儿中,内化症状未显示与M-CHAT-R/F评分升高相关.M-CHAT-R/F的解释应包括对同时发生的精神疾病的考虑，尤其是外化条件，如多动症。
方法：在2018年至2021年期间，从四家初级保健诊所招募了幼儿。他们的照顾者完成了M-CHAT-R/F以及儿童行为清单（CBCL），一个经过充分验证的，情绪和行为功能的规范测量。评估相关性和分组分析以检查CBCL量表与M-CHAT-R/F评分之间的关系。
结果：招募了1765名幼儿进行研究。内化的CBCL分数，外部化，自闭症,多动症,焦虑量表与M-CHAT-R/F评分均呈适度正相关。与仅自闭症量表得分较高的幼儿相比，自闭症和ADHD/外化量表均升高的幼儿的M-CHAT-R/F得分较高。相比之下,仅与自闭症和内化量表得分均较高的幼儿相比，自闭症量表得分较高的幼儿之间的得分没有显着差异。
结论：研究结果表明，对于自闭症行为升高的儿童，外化症状的存在，包括多动症相关的问题，与M-CHAT-R/F上的分数升高相关。相比之下,在自闭症相关行为升高的幼儿中,内化症状未显示与M-CHAT-R/F评分升高相关.M-CHAT-R/F的解释应包括对同时发生的精神疾病的考虑，尤其是外化条件，如多动症。
