Abstract
BACKGROUND: Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition that requires early diagnosis and intervention for the improvement of the patient's skills and functioning. Several guidelines, therefore, recommend the screening of all children for ASD. This study determined the outcomes of ASD screening program in Primary Healthcare Centers (PHCs) in Bahrain. MATERIALS AND METHODS: A cross-sectional study was conducted in 12 of the 27 PHCs in Bahrain. The Modified Checklist for Autism in Toddlers-Revised (MCHAT-R) was completed for children who attended the selected centers. Findings from the checklists and the outcome of positive screening cases were recorded. MCHAT-R scores of <3 were indicative of a low risk for ASD. Children with moderate and high MCHAT-R risk were referred for psychiatric assessment. SPSS version 25.0 was used for data analysis; mean and standard deviation were calculated for continuous variables, and categorical variables presented as frequency and percentage. Chi-square test or Fisher's exact test, as appropriate, used to test for statistical significance. RESULTS: A total of 3729 MCHAT-R checklists of children with a mean age of 2 years were included. Most children were Bahraini (78.0%), half of whom were males (51.3%). While most of the children (98.8%) had a low-risk MCHAT-R score, 1.2% had a moderate-high risk MCHAT score (12.33/1000). Of the cohort, 19 cases (0.51%) had ASD, 5.10/1000 children. Nearly two-thirds of children with confirmed ASD were males ( 63.2%), and one-third were females (36.8%). In addition, 14 cases (41.2%) of those who had moderate-high MCHAT refused to follow the subsequent diagnostic protocol. CONCLUSION: This study revealed a low prevalence of positive MCHAT-R screening and confirmed ASD cases. The vast majority of children who were positive on screening had a confirmed diagnosis of ASD. Some cases with positive MCHAT results failed to follow up for diagnosis. Therefore, improving parental and community awareness regarding ASD is important for a better outcome.