Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R-F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia.

Bali Medical Journal (Bali Med J) 2016, Volume 5, Number 2: 133-137 P-ISSN.2089-1180, E-ISSN.2302-2914 Open access: www.balimedicaljournal.org and www.ojs.unud.ac.id 133 Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia. I Gusti Ayu Trisna Windiani1, Soetjiningsih2, I Gusti Agung Sugitha Adnyana3, Kadek Apik Lestari4* 1-3Lecturer, 4Resident Department of Child Health, School of Medicine, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia *Corresponding: Email: kadekapiklestari@gmail.com Background: Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired reciprocal social interaction and communication, and by a restricted, repetitive or stereotyped behavior. Early detection of autism is recommended on all toddlers from the ages of 9 months because of increasing in prevalence. The Modified Checklist for Autism (M-CHAT) in Toddlers, a Revised with Follow-Up (M-CHAT-R/F) is a 2-stage parent-report screening tool to assess a risk for ASD and it demonstrates an improvement compared to the original M-CHAT. It is translated to Indonesian language by Soetjiningsih and colleagues, and it needs to be validated. Methods: This is a diagnostic accuracy study conducted at Sanglah Hospital, Bali, conducted from March 2015 to December 2016. We included children 18-48 months in this study. The parents of the outpatient children in the growth and development clinic of Sanglah Hospital were asked to fill out the Indonesian M-CHAT-R/F form. In the same visit, the Autism Spectrum Disorder (ASD) assessment according to the DSM-5 as a gold standard was done by the researchers, without knowing the M-CHAT-R/F result. The assessment comparison based on M-CHAT-R/F and DSM-5 was analyzed to obtain the AUC intersection on ROC curve that gives the best sensitivity and specificity. Results: We found 10.71% of our outpatient was diagnosed with autism according to DSM 5, when they are 18-24 months old. The Indonesian version of M-CHAT-R/F as an ASD screening tool has 88.9% in sensitivity and 94.6% in specificity. Conclusion: Our results suggest that the Indonesian translation of the M-CHAT-R/F is an effective screening instrument for ASD, particularly when a two-step screening process is used. Keywords: M-CHAT-R/F, Modified Checklist for Autism, Autism Spectrum Disorder, validity test