2 - (SYM 120) Connecting Families to Appropriate Levels of Care: Examination of M-CHAT Usage in a
Tribal Health System's Pediatric Primary Care Clinic

American Academy of Pediatrics recommends autism screening as early as 18-24 months. Screening in pediatric primary care provides opportunity for the early identification of autism spectrum disorder (ASD) and linkage to formal evaluation and treatment if warranted. Delayed identification or missed identification of ASD may have a profound impact on the child and family. The Modified Checklist for Autism in Toddlers (M-CHAT) is a commonly administered screening instrument in pediatric clinics and is linked with early identification of ASD (Carbone et al., 2020). Currently, there is a dearth of ASD research with the American Indian (AI) population with minimal data on occurrence rate and instrument psychometrics. The current presentation will be an initial examination of ASD occurrence in an AI community and will explore clinical utility of the M-CHAT among AI people. We will also explore process for follow-up or referral following a positive M-CHAT screening. Cherokee Nation Health Services (CNHS) serves members of any of the 574 federally recognized tribes in the United States. The research team will review patient charts for inclusion in the analyses. Participants included in the study will be toddlers aged 16 to 30 months, enrolled in a federally recognized tribal nation, and were seen through CNHS pediatric primary care clinic. Visits occurring between January 2019 and January 2023 will be included in the analyses. Confirmatory Factor Analyses will be conducted to examine measurement invariance to identify possible differences in the M-CHAT among AI families. Planned analyses will also include examining age of diagnosis to examine M-CHAT sensitivity, positive predictive value and negative predictive value. This project addresses a gap in the literature regarding ASD screening among a population often neglected in academic literature. Furthermore, this project will assess current practices in our health clinic to improve early identification of ASD and service delivery to families.