Detection of autism spectrum disorders using the questionnaire M-CHAT R / F: The importance of considering socio-cultural and language aspects

Abstract

Introduction: The influence of language and socio-cultural environment on the development of cortical connections is well known, but also, the existence of alterations in autism spectrum disorders (ASD). The present study evaluated potential differences in the detection of ASD, depending on the language and socio-culture of the population. Method: A search of publications was carried out in: PUBMED, Google Scholar, and EPISTEMONIKOS from 2010 to 2020, which validated the use of the M-CHART R/F questionnaire in the early ASD detection in patients between 12-36 months of age, without risk factors and in any country. The meta-analysis included three reviewers who evaluated eligibility and extracted the data. The heterogeneity and consistency between studies, and the specific differences between each one with the main validation study, were evaluated, including, the positivity of the phase 1 and its confirmation in the follow-up of each case. Results: Eight articles met the inclusion criteria, were carried out in the United States, Argentina, France, Spain, Turkey, Saudi Arabia, Albania and Korea, in their official languages, for a total of 36,842 children. Heterogeneity was low (OR<0.42) for most subsets of the meta-analysis, except for the results obtained in Korea (OR=7.64). There is an association in results between countries (excluding Korea) OR=0.196 [0.178-0.216]; p<10^-10. All studies showed significant differences in detection compared to the original validation study. Conclusion: The MCHAT R/F is a valid method for screening for suspected ASD in the general population, but it is independent of the culture and language of the country.