WIP 87 - Black Mothers’ Perspectives on the MCHAT and the Autism-Screening Process in Primary Care

Poster Number: WIP 87
Publication Number: WIP 87.825

Background: The Modified Checklist for Autism in Toddlers (M-CHAT) is the most widely used autism screening tool, both in the United States and Internationally. Many researchers have concerns regarding the M-CHAT’s accuracy (e.g., sensitivity, specificity and positive predictive value) with populations of color, as the population-based screener was developed and validated primarily with White children. To improve the M-CHAT’s accuracy, research must explore racially and ethnically diverse experiences with the tool, especially with Black families who were under-represented in early validation studies. Research on Black families’ experiences with the M-CHAT highlight challenges with the early screening process, rather than specific experiences with the M-CHAT, such as poor provider-caregiver dynamics, cultural barriers, and inaccessible services. Black families’ experiences and preferences with the tool itself remain underexplored. As we aim to improve early autism detection, it is essential that we understand Black caregivers’ perspectives and experiences with the M-CHAT specifically.

Objective: To use qualitative methodology to understand Black caregivers' 1) perspectives on the M-CHAT screening process and 2) preferences for receiving screening results and communications related to M-CHAT screening.

Design/Methods: All participants were parents of a child who received a positive M-CHAT screen during a visit in a pediatric primary care practice associated with an academic medical center in Pennsylvania or New Jersey, who also self-identified as Black. A total of 10 Black mothers completed one-on-one semi-structured interviews. The IRB at Children’s Hospital of Philadelphia approved all study procedures. We audio-recorded, transcribed, and used NVivo software for data management for all interviews. We are completing thematic qualitative coding, and plan to finalize coding and thematic analysis by February of 2024. Emerging themes relate to parent trust in clinicians, preferred sources of information about autism and child development, and preferences for screening processes.