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      Preliminary data of a preschool teacher-screening checklist for autism spectrum disorder in Singapore

      Advances in Autism

      Emerald Publishing

      Singapore, Preschool, Autism spectrum disorder, DSM-5, Screening checklist

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          There are limited tools developed for preschool teachers to aid them in identifying these children with possible autism spectrum disorder (ASD). This study aims to describe the development and present preliminary data of a checklist for ASD screening for preschool teachers (CAPT-S) in Singapore that is easy for preschool teachers to use to identify ASD in mainstream preschoolers from 3 to 6 years old.


          This study adopted a cross-sectional questionnaire design. The CAPT-S is a 12-item checklist based on the current Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition criteria and derived from a survey in a previous study that examined preschool teachers’ perceptions of challenging behaviors in preschoolers with ASD in Singapore. Participants consisted of 63 preschool teachers (mean age = 29.4 years; SD = 9.8) teaching in mainstream preschool centers located in Singapore, and they were asked to use the CAPT-S to rate their students on a four-point Likert scale on frequency of observed behavior.


          Preliminary results indicated construct validity was demonstrated and high reliability in terms of internal consistency and moderate test–retest reliability of the CAPT-S. Diagnostic validity of the CAPT-S was also established, even after controlling for variables such as working experience and time spent working with that student. The optimal cutoff score of 24 produced high sensitivity and specificity.


          The present study adds an important contribution to the literature on using preschool teachers as an additional informant in the screening process of ASD. The CAPT-S may be suitable for preschool teachers to use to identify children with possible ASD, although future studies would need to be conducted to examine its effectiveness.

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          Most cited references 32

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          Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders.

           Brian Reichow (2012)
          This paper presents an overview of 5 meta-analyses of early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASDs) published in 2009 and 2010. There were many differences between meta-analyses, leading to different estimates of effect and overall conclusions. The weighted mean effect sizes across meta-analyses for IQ and adaptive behavior ranged from g = .38-1.19 and g = .30-1.09, respectively. Four of five meta-analyses concluded EIBI was an effective intervention strategy for many children with ASDs. A discussion highlighting potential confounds and limitations of the meta-analyses leading to these discrepancies and conclusions about the efficacy of EIBI as an intervention for young children with ASDs are provided.
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            Is Open Access

            Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

            Problem/Condition Autism spectrum disorder (ASD). Period Covered 2016. Description of System The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years whose parents or guardians live in 11 ADDM Network sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). Surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by medical and educational service providers in the community. In the second phase, experienced clinicians who systematically review all abstracted information determine ASD case status. The case definition is based on ASD criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results For 2016, across all 11 sites, ASD prevalence was 18.5 per 1,000 (one in 54) children aged 8 years, and ASD was 4.3 times as prevalent among boys as among girls. ASD prevalence varied by site, ranging from 13.1 (Colorado) to 31.4 (New Jersey). Prevalence estimates were approximately identical for non-Hispanic white (white), non-Hispanic black (black), and Asian/Pacific Islander children (18.5, 18.3, and 17.9, respectively) but lower for Hispanic children (15.4). Among children with ASD for whom data on intellectual or cognitive functioning were available, 33% were classified as having intellectual disability (intelligence quotient [IQ] ≤70); this percentage was higher among girls than boys (40% versus 32%) and among black and Hispanic than white children (47%, 36%, and 27%, respectively). Black children with ASD were less likely to have a first evaluation by age 36 months than were white children with ASD (40% versus 45%). The overall median age at earliest known ASD diagnosis (51 months) was similar by sex and racial and ethnic groups; however, black children with IQ ≤70 had a later median age at ASD diagnosis than white children with IQ ≤70 (48 months versus 42 months). Interpretation The prevalence of ASD varied considerably across sites and was higher than previous estimates since 2014. Although no overall difference in ASD prevalence between black and white children aged 8 years was observed, the disparities for black children persisted in early evaluation and diagnosis of ASD. Hispanic children also continue to be identified as having ASD less frequently than white or black children. Public Health Action These findings highlight the variability in the evaluation and detection of ASD across communities and between sociodemographic groups. Continued efforts are needed for early and equitable identification of ASD and timely enrollment in services.
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              Comparison of five rules for determining the number of components to retain.


                Author and article information

                Advances in Autism
                Emerald Publishing
                14 August 2020
                03 December 2020
                : 6
                : 4
                : 303-313
                National Institute of Education, Nanyang Technological University , Singapore
                Author notes
                Yong-Hwee Nah can be contacted at:
                650519 AIA-01-2020-0005.pdf AIA-01-2020-0005
                © Emerald Publishing Limited
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 33, Pages: 1, Words: 5921
                research-article, Research paper
                cat-HSC, Health & social care
                , Learning & intellectual disabilities
                Custom metadata
                Web-ready article package

                Health & Social care

                DSM-5, Autism spectrum disorder, Preschool, Singapore, Screening checklist


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