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  • Clinical Research Article
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Autism screening tool validation for toddlers and young children: advantages and limitations

Pediatric Research volume 98, pages 1039–1045 (2025)Cite this article

Abstract

Background

Early identification is crucial for children with autism. However, many children are diagnosed later due to the lack of specific assessment tools in primary care settings. The study aims to evaluate the effectiveness of the STAT in screening autism across different age groups while assessing its advantages and limitations.

Methods

In total, 434 children aged 14–48 months visiting autism clinics from March to December 2021 were included. Subjects were grouped by age (14–23, 24–36, and 37–48 months) and categorized based on clinical evaluations and STAT results.

Results

In the age groups of 14–23 and 24–36 months, STAT results demonstrated high sensitivity and specificity compared to DSM-5 diagnoses and exhibited better consistency with ADOS-2 results. However, its performance was weaker in the 37–48 months group. False-negative results were associated with less pronounced autistic traits and higher developmental quotients.

Conclusion

STAT presents as a promising level 2 screening tool for early autism identification in China, but its accuracy diminishes in older children with less pronounced autistic traits. These findings emphasize the need for comprehensive assessment strategies for autism diagnosis across different age groups and varying levels of support needs.

Impact

  • This study evaluates the effectiveness of the Screening Tool for Autism in Toddlers (STAT) for early screening of autism across different age groups.

  • It highlights STAT’s effectiveness in younger age groups but emphasizes its limitations with older children and those with less pronounced autistic traits.

  • The findings supplement existing literature by providing insights into STAT’s utility in diverse populations.

  • The impact lies in guiding clinical practice to improve the identification of autistic characteristics, particularly in resource-limited settings, potentially enhancing early support and outcomes for autistic children.

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Fig. 1: STAT screening and research process.

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Data availability

All the data and materials are available. The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

This study was supported by the Science and Technology Department of Jilin Province (Grant No.: 20230203067SF), The Health Science and Technology Capacity Improvement Project of Jilin Province (Grant Number: 2022LC104), and Tianhua Health Foundation of Jilin Province(Grant Number: J2022JKJ019).

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Authors and Affiliations

  1. Department of Developmental and Behavioral Pediatrics, Children’s Medical Center, The First Hospital of Jilin University, Jilin University, Changchun, China

    Miaoshui Bai, Yang Xue, Hanyu Dong, Zakaria Ahmed Mohamed & Feiyong Jia

  2. The Child Health Clinical Research Center of Jilin Province, Changchun, China

    Miaoshui Bai, Yang Xue, Hanyu Dong, Zakaria Ahmed Mohamed & Feiyong Jia

  3. Jilin University, Changchun, China

    Miaoshui Bai, Yang Xue, Hanyu Dong, Zakaria Ahmed Mohamed & Feiyong Jia

Authors
  1. Miaoshui Bai
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  2. Yang Xue
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  3. Hanyu Dong
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  4. Zakaria Ahmed Mohamed
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  5. Feiyong Jia
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Contributions

F.-Y.J., M.S.B., and Y.X. significantly contribute to concept and design, data acquisition, and data analysis and interpretation. H.Y.D. and Z.A.M. critically revise articles and provide important intellectual content. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Feiyong Jia.

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Competing interests

The authors declare no competing interests.

Consent statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the Kunming Changhe Tiancheng Rehabilitation Hospital. Informed consent was obtained from all subjects involved in the study.

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Bai, M., Xue, Y., Dong, H. et al. Autism screening tool validation for toddlers and young children: advantages and limitations. Pediatr Res 98, 1039–1045 (2025). https://doi.org/10.1038/s41390-025-03848-x

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