Validation of two parent-reported autism spectrum disorders screening tools M-CHAT-R and SCQ in Bamako, Mali

• Published in: eNeurologicalSci Vol. 15; p. 100188
• Main Authors: Sangare, Modibo, Toure, Hamza B., Toure, Amadou, Karembe, Adama, Dolo, Housseini, Coulibaly, Yaya I., Kouyate, Modibo, Traore, Kadiatou, Diakité, Seidina A., Coulibaly, Souleymane, Togora, Arouna, Guinto, Cheick Oumar, Awandare, Gordon A., Doumbia, Seydou, Diakite, Mahamadou, Geschwind, Daniel H.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2019; Elsevier
• Subjects: M-CHAT-R; Mali; NPV; Original; PPV; SCQ; M-CHAT-R; SCQ; DSM-V; ICD-10; DRS; LR; CSCOM; DNS; FMOS; AUC; USTTB; CHU; ASD; FAPH; CSRef; NPV; Mali; AMALDEME; PPV; M-CHAT-R/F; AUC, Area under the Curve; CSRef, District health centers; CHU, University hospital centers; FMOS, Faculty of medicine and odonto-stomatology; ICD-10, International Statistical Classification of Diseases and Related Health Problems-10; LR-, Negative likelihood; SCQ, Social communication questionnaire; DNS, National direction of health; M-CHAT-R/F, Modified checklist for autism in toddlers-Revised/Follow up; FAPH, Faculty of Pharmacy; PPV, Positive predictive value; M-CHAT-R, Modified checklist for autism in toddlers-Revised; LR+, Positive likelihood; DSM-V, Diagnostic and Statistical Manual of Mental Disorders; CSCOM, Community health centers; NPV, Negative predictive value; ASD, Autism spectrum disorders; USTTB, University of Sciences, Techniques and Technologies of Bamako; AMALDEME, Malian association for mental deficiencies; DRS, Regional direction of health
• ISSN: 2405-6502; 2405-6502
• DOI: 10.1016/j.ensci.2019.100188

Early screening is crucial for early autism spectrum disorders (ASD) diagnosis and intervention. ASD screening tools have mostly been constructed based on the Western cultural context. We hypothesized that their use in Mali may require a prior validation. To validate the modified checklist for autism in toddlers-Revised (M-CHAT-R) and the social communication questionnaire (SCQ) in the Malian sociocultural context for ASD screening. We administered M-CHAT-R and SCQ in 947 toddlers aged 16–30 months old at the district and community health centers in Bamako and 120 patients (60 autistic and 60 age and sex matched controls) aged ≥4 years old at the psychiatry department in Bamako. Toddlers at moderate to high risk of ASD underwent M-CHAT-R/F and clinical evaluation by an ASD multidisciplinary team. M-CHAT-R and SCQ were evaluated for cultural appropriateness by Malian anthropologists. The sensitivity, specificity, PPV, NPV were determined for both M-CHAT-R and SCQ. Health professionals have been trained during ASD seminary on how to use M-CHAT-R and SCQ for ASD screening in Bamako. We found for the M-CHAT-R a sensitivity of 50%, a specificity of 100%, a PPV of 100% and a NPV of 87%. The SCQ had a sensitivity of 71%, a specificity of 72%, a PPV of 73% and a NPV of 70%. We have found four out of 20 items on the M-CHAT-R that were culturally inappropriate in the Malian context. M-CHAT-R and SCQ can be used for early autism screening in Mali. In the future, we plan to train a descent number of Malian physicians in chief and pediatricians at the district hospitals across the country to integrate the early ASD screening into the national health system. M-CHAT-R has a perfect specificity and SCQ a fair diagnostic accuracy for ASD in Mali.