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Autism screening and conditional cash transfers in Chile: Using the Quantitative Checklist (Q-CHAT) for early autism detection in a low resource setting
Indexado
WoS WOS:000627525700001
Scopus SCOPUS_ID:85097761522
DOI 10.1177/1362361320972277
Año 2021
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Diagnosis of Autism Spectrum Conditions (ASC) can be an extended procedure since ASC tend to both vary greatly across individual symptoms and diagnostic pathways with serious challenges to opportune access and diagnosis in low resource settings. We adapted the Q-CHAT-25 for use in a routine health check-ups programme at Chilean primary health clinics by developing a 10-item version of this questionnaire recruiting n = 287 (F: 112/M: 175) participants (Controls: n = 125, F: 58/M: 67; Developmental Delay: n = 149, F: 53/M: 96; Autism Spectrum Conditions: n = 13, F: 1/M: 12). Our findings show that the Q-CHAT-10 can be successfully applied in health-check programmes. The results for the Q-CHAT-10 show high internal consistency (Cronbach’s α: 0.85) and good overall performance, significantly correlating (r = 0.79, p < 0.0001) with the Q-CHAT-25. The Q-CHAT-10 had a sensitivity of 92.86% and a specificity of 76.86% in the Developmental Delay sample. The positive predictive value was 48% with a positive likelihood ratio of 4.01 and a negative likelihood ratio of 0.09 with a post-test probability of disease of 19%. This study provides evidence that the implementation of Autism Spectrum Condition screening programmes using the Q-CHAT-10 is a cost-effective measure that improves diagnosis of Autism Spectrum Conditions in those participating in conditional cash transfer programmes in low- and middle-income countries or low resource setting in high income countries. Lay abstract: Getting a diagnosis of autism can take long, because autism is different across people, but also because it depends on the way it gets diagnosed. This is especially important in poorer countries or in the case of poor people living in wealthier countries that have significant groups of disadvantaged communities. We adapted a 10-item version of the Q-CHAT-25 questionnaire for use in routine health check-ups programme in Chile and recruited 287 participants under the age of three divided into three groups: Controls (125), Developmental Delay (149) and Autism Spectrum Condition (13). Our results show that a short questionnaire for autism screening can be successfully applied in a health-check programme in poor resource settings. Our results show that our questionnaire had good overall performance, not different to its longer version, the Q-CHAT-25. Our questionnaire was autism specific, with good sensitivity and reliability, and is suitable to be used in a screening setting. This study provides evidence that the implementation of Autism Spectrum Condition screening programmes using the Q-CHAT-10 provides value for money and improves diagnosis of Autism Spectrum Condition in those participating in routine health check-up programmes in developing countries or poor areas of wealthy countries.

Revista



Revista ISSN
Autism 1362-3613

Métricas Externas



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Disciplinas de Investigación



WOS
Psychology, Developmental
Psychology, Development
Scopus
Developmental And Educational Psychology
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Roman-Urrestarazu, Andres Hombre Autism Research Centre - Reino Unido
Cambridge Institute of Public Health - Reino Unido
UNIV CAMBRIDGE - Reino Unido
2 Yáñez, Carolina Mujer Universidad de Chile - Chile
3 Lopez-Gari, Claudia Mujer Universidad de Chile - Chile
4 Elgueta, Constanza Mujer Universidad de Chile - Chile
5 Allison, Carrie Mujer Autism Research Centre - Reino Unido
UNIV CAMBRIDGE - Reino Unido
6 Brayne, Carol Mujer Cambridge Institute of Public Health - Reino Unido
UNIV CAMBRIDGE - Reino Unido
7 TRONCOSO-SCHIFFERLI, LUCY MONICA Mujer Universidad de Chile - Chile
8 Baron-Cohen, Simon Hombre Autism Research Centre - Reino Unido
UNIV CAMBRIDGE - Reino Unido

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Financiamiento



Fuente
European Union
Medical Research Council
Wellcome Trust
Horizon 2020
Horizon 2020 Framework Programme
National Institute for Health Research
European Federation of Pharmaceutical Industries and Associations
MRC
Innovative Medicines Initiative
EFPIA
Simons Foundation Autism Research Initiative
AUTISM
Autism Research Trust
NIHR Cambridge Biomedical Research Centre
National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust
Autistica
SFARI
Innovative Medicines Initiative 2 Joint Undertaking (JU)
Gillings Fellowship in Global Public Health and Autism Research
AUTISM SPEAKS

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Agradecimientos



Agradecimiento
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: A.R-U. received funding from the Gillings Fellowship in Global Public Health and Autism Research, Grant Award YOG054 to the Cambridge Institute of Public Health (PI Carol Brayne). S.B-C. received funding from Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 777394. The JU receives support from the European Union?s Horizon 2020 research and innovation programme and EFPIA and AUTISM SPEAKS, Autistica, SFARI. S.B-C. also received funding from the Autism Research Trust, Autistica, the MRC, the Wellcome Trust and the NIHR Cambridge Biomedical Research Centre. The research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: A.R-U. received funding from the Gillings Fellowship in Global Public Health and Autism Research, Grant Award YOG054 to the Cambridge Institute of Public Health (PI Carol Brayne). S.BC. received funding from Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 777394. The JU receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA and AUTISM SPEAKS, Autistica, SFARI. S.B-C. also received funding from the Autism Research Trust, Autistica, the MRC, the Wellcome Trust and the NIHR Cambridge Biomedical Research Centre. The research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.

Muestra la fuente de financiamiento declarada en la publicación.