Early detection of autism in childhood outpatient department practice: insight from pediatric neurology in Hyderabad, India

Background: Autism spectrum disorder (ASD) is prevalent neurodevelopmental disorder marked by core challenges in social communication, social interaction and presence of restrictive and repetitive behaviors. Early identification through effective screening is essential, as timely intervention significantly enhances developmental outcomes. Methods: This descriptive cross-sectional study was conducted on a sample of 506 children aged 16 to 30 months attending the pediatric OPD clinic. Eligible children who met the inclusion criteria were screened for the risk of autism using the revised modified checklist for autism in toddlers (Revised M-CHAT). Results: Among 506 children screened with the revised M-CHAT tool, 1.6% screened positive for ASD. The study population had a mean age of approximately 21.6 months without male predominance (59.6%). Key factors significantly associated with positive ASD screening included partial immunization, preterm birth, lack of exclusive breastfeeding, and exposure to more than 2 hours of screen time. Other demographic variables such as gender, mode of delivery, and parental education showed no significant association. Revised M-CHAT questionnaire items (notably questions 1, 2, 7, 10, and 12) were frequently positive among ASD screen-positive children, suggesting particular sensitivity for screening. Breastfeeding, screen-time exposure and immunization are confirmed statistically by this study. Conclusions: All toddlers attending Pediatric clinics should be routinely screened for autism by a child specialist. The revised M-CHAT is a simple, easy-to-administer, and validated screening tool suitable for use in busy pediatric outpatient settings.