Can Screening with the Ages and Stages Questionnaire Detect Autism?

Sarah Hardy, Lauren Haisley, Courtney Manning, Deborah Fein

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Objective: Parents rely on pediatricians to monitor their child's development. The American Academy of Pediatrics recommends routine developmental screening with both broadband and autism-specific instruments at specified ages. If broadband screeners can detect autism risk, this might minimize the burden of administering autism-specific screens to all children. The current study examines the ability of the Ages and Stages Questionnaire-Third Edition (ASQ-3) to identify children at risk for autism. We looked at ASQ-3 scores of children who screen positive on the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R), children who continue to screen positive on the M-CHAT-R Follow-up Interview, and children diagnosed with autism spectrum disorder (ASD). Methods: A total of 2848 toddlers, aged 16 to 30 months, were screened with the ASQ-3 and M-CHAT-R across 20 pediatric sites. Children who screened positive on the M-CHAT-R and its follow-up interview were offered a diagnostic evaluation. Results: Using the "monitor and/or fail" cutoff on any domain, the ASQ-3 identified 87% of the children who screened positive on the M-CHAT-R with follow-up and 95% (20/21) of those diagnosed with an ASD. Monitor and/or fail on the Communication domain alone also identified 95% of the diagnosed children. Conclusions: Scores below the "monitor" cutoff on the Communication domain of the ASQ-3 can indicate initial concern requiring autism-specific follow-up. If these results are confirmed with a sample large enough to separately examine toddlers of different ages and different cultural backgrounds, it may be feasible to implement a 2-stage screening strategy, with autism-specific screening reserved for those who are positive on a broadband screen.

Original languageEnglish (US)
Pages (from-to)536-543
Number of pages8
JournalJournal of Developmental and Behavioral Pediatrics
Issue number7
StatePublished - Sep 12 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc.


  • Ages and Stages questionnaire-Third Edition (ASQ-3)
  • Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R/F)
  • autism spectrum disorder (ASD)
  • developmental screening
  • pediatrics


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