心理学与心理疗法杂志
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自闭症谱系障碍的早期筛查：系统评价

Alessandro Silveira, Luciano Dias de Mattos Souza

Introduction: Autism Spectrum Disorder (ASD) is characterized by impairments in social communication and the presence of repetitive and stereotyped behaviors. Data indicate a prevalence of 2.7% in childhood, and early interventions have a significant effect when administered before the age of 4.

Objectives: To review the scientific literature on screening scales for ASD developed for children up to 36 months, identify the instruments, compare their accuracies, and organize them according to their screening levels 1 (universal screening) and 2 (diagnostic support).

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, two judges independently performed article selection and data extraction. Searches were conducted in the PubMed, Virtual Health Library (VHL), Scielo, PsycINFO, and Google Scholar databases, with filter for the period between 2013 and 2022. A total of 815 articles were found, of which 22 were included in this review. The study was registered in PROSPERO: “CRD42022343562”.

Results: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) emerged as the most accurate instrument at level 1, while at level 2, the Autism Diagnostic Observation Schedule-Toddler Module (ADOS-2-T) stood out. The Social Attention and Communication Surveillance-Revised (SACS-R) showed the best indicators regardless of the screening level. In the Brazilian context, the M-CHAT-R/F is the only fully adapted instrument. Scales that assess more specific age ranges and involve interactive follow-up interviews by professionals are more suitable for screening purposes. These findings can contribute to clinical practice guidelines and research on early diagnosis of ASD.