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Journal of Tropical Pediatrics Advance Access published online on April 28, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp031
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Screening of 18–24-Month-Old Children for Autism in a Semi-Urban Community in Sri Lanka

H. Pereraa,b, K. Wijewardenac and R. Aluthwelagec

aDepartment of Psychological Medicine, Faculty of Medicine, University of Colombo, Kinsey Road, Colombo 008, Sri Lanka
bLady Ridgeway Hospital for Children, Colombo 008, Sri Lanka
cDepartment of Community and Family Medicine, Faculty of Medical Sciences, University of Sri Jayawardenapura, Gangodawila, Nugegoda, Sri Lanka

Correspondence: Prof. H. Perera, Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Kinsey Road, Colombo 008, Sri Lanka.

E-mail <hemamali_p{at}yahoo.com>.


  Abstract

All children aged 18–24 months in a defined geographical area were initially screened for autism, using ‘Red Flag’ criteria. All the children with one or more positive ‘Red Flag’ signs were further screened using Modified Checklist for Autism in Toddlers (M-CHAT) translated to Sinhala, followed by a comprehensive clinical assessment. Of a sample of 374 children, ‘Red Flag’ signs were positive in 28 (7.4%). Four children received a diagnosis of autism on clinical assessment giving a prevalence of 1.07% or 1 per 93 in the 18–24-month age group. Sensitivity of M-CHAT was only 25%, and specificity 70%. The high prevalence detected strongly justifies early community-based screening, but a culturally sensitive screening tool needs to be developed for Sri Lanka.

Key Words: autism • screening • M-CHAT • ‘Red Flag’ signs • prevalence


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