A Study on Screening of Autism Spectrum Disorder among Toddlers using M-Chat-R Scales

INTRODUCTION: Childhood Autism belongs to the group of Pervasive Developmental Disorders, which are neurodevelopment syndromes characterized by impairment in reciprocal social interaction, impairment in communication, restricted repetitive and stereotyped patterns of behavior, interests and activities.1Diagnostic and Statistical Manual of mental disorders (DSM-V) defines a patient with autism spectrum disorders as having persistent deficits in social communication and social interaction which encompass deficits in social-emotional reciprocity, deficits in non-verbal communicative behaviors used for social interaction, and deficits in developing and understanding relationships. M-CHAT-R Scale is used for screening the Autism Spectrum Disorder in child age of 16 months to 30 months. It is validated scale used for screening Autism spectrum disorder. There are 20 Yes or No types of questioner answered by parents. Questioner has been translated in to Tamil language. According to the response marks scored. Score <3 screening was negative. If the child age < 24 months at the end of 24 months repeat the screening test. If the score 3– 7 repeat the follow up screening or refer to psychiatrist for further screening. Score more than 8 directly send to psychiatrist for treatment. Recent increase in the prevalence of ASD early identification and early intervention is needed. The early intervention provides optimal life of affected individual and their family. We can identify as early as 24 months of life. Pediatrician can use M-CHAT- R scale for screening the child for ASD. The Pediatrician is the first contact medical person to the child. Pediatricians are responsible for early identification of ASD and early referral to psychiatrist to for early intervention. AIM OF THE STUDY: A study on screening of autism spectrum disorder among toddlers using M-CHAT-R scales. OBJECTIVES: 1. To study the early diagnosis autism spectrum disorder in toddlers using M-CHAT-R scales. 2. To study the factors influence in autism like exclusive breastfeeding, immunization. 3. To study the age at diagnosis, gender differentiation and perinatal risk factors of autism. METHODOLOGY: It is a cross sectional study. Consecutive children who were between 16 months -24 months of age attending Pediatric OP were assessed for Autism using M-CHAT-R scale. Study period one year. Of these children evaluated during the study period, 522 children met the inclusion criteria. Parents of 3 children didn’t consent for the study and 17 children had co-morbid neurological illness and they were excluded. Hence, the study was conducted in a sample of 502 children- which comprises of 275 males and 227 female children. RESULTS: Prevalence of Autism Spectrum Disorder among my study population is 1 in 100. Mean age of early symptoms identification is 22.80 months average of 20 – 24 months. Male children are more affected than female children Male : Female = 4 : 1. Preterm delivered children are more affected than term gestation delivered children. LSCS delivered children are more affected than labour natural delivered children. Exclusive breastfed children less likely affected than suboptimal breastfed children. Partially immunized children affected significantly than fully immunized children. CONCLUSION: There is increasing trend of ASD in the general population. Early identification and early intervention helps the affect children to live optimal life. Improve the prenatal and perinatal care. Create awareness about exclusive breast feed and fully immunization in general population