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Early Screening of Autistic Traits

The Early Screening of Autistic Traits (ESAT; Swinkels et al., 2006) is a 19-item screening checklist for parents/caregivers of 14-month old infants. It is primarily used by health practitioners at well-baby visits.

ESAT is not a commercial product and can be downloaded in its entirety.

Overview

The Early Screening of Autistic Traits (ESAT; Swinkels et al., 2006) is a 19-item screening checklist for parents/caregivers. The questionnaire is designed for 14-month-old infants. The tool is designed to be administered by health practitioners at well-baby visits. Failure on three or more items (i.e., parent answers more than three questions “no”, the child is eligible for continued screening) suggests the need for a diagnostic evaluation. This research measure is not commercially available but can be accessed at the site below the summary table. To note, sensitivity and specificity were not reported about the measure by its developers, but the positive predictive value (PPV) was 0.25 (Dietz et al., 2006; Swinkels et al., 2006) and it identified 18 ASD cases from 31,724 screened. On this basis, Zwaigenbaum and colleagues (2015) have called for additional data regarding the use of this instrument before recommending its use as a screener.

Summary

Age: 1 year

Time to Administer: 10-15 minutes

Method of Administration: 19-item screening checklist for Parents/caregivers, administered by health practitioner
Yes/no responses
Yields cutoff score

Subscales: Pretend Play; Joint Attention; Interest in Others; Eye Contact; Verbal and Nonverbal Communication; Stereotypes; Preoccupations; Reaction to Sensory Stimuli; Emotional Reaction; Social Interaction

Screening/Diagnosis: S

Autism Related Research

Beuker et. al (2014)

Age Range: 18 months

Sample Size: 12,948

Topics Addressed:

Comparison of screening results on ESAT vs. M-CHAT

Outcome:Beuker et. al (2014)

The M-CHAT yielded significantly more positive screens compared with the ESAT (6.4% to 0.5%, respectively), suggesting the possibility of overinclusivity of the M-CHAT or a too conservative ESAT. M-CHAT psychometric properties have been tested in the general population, but ESAT has not been studied as extensively. The ESAT was associated with more clinical referrals and tended to identify more children with medical, language, and behavioral problems. Further analysis showed that combining the two instruments is more effective than the individual instruments alone in identifying children referred to clinical services at 18 months of age.

Conclusion: use of two screening instruments is recommended because not all screening instruments (e.g., these two) may identify different problems.