Comparison between the Clancy Behavior Scale and the Modified Checklist for Autism in Toddlers in Taiwan



Autism spectrum disorder (ASD) is a neurodevelopmental condition that impacts a child’s social communication, interaction, and behavior patterns. Early detection of ASD is crucial for maximizing the effectiveness of intervention strategies and improving long-term outcomes. In the relentless pursuit of early identification, researchers are constantly evaluating tools that can effectively screen young children for ASD.

This blog post delves into a recent study published in May 2024 that specifically investigated the effectiveness of two commonly used ASD screening tools in toddlers in Taiwan: the Clancy Behavior Scale (CBS) and the Modified Checklist for Autism in Toddlers (M-CHAT).


Decoding the Tools: CBS vs. M-CHAT


The Clancy Behavior Scale (CBS) is a parent-reported questionnaire designed to assess behaviors potentially associated with ASD in toddlers. Parents are asked to rate their child’s behavior on a scale, evaluating areas such as social interaction, communication skills, sensory processing, and repetitive behaviors. This comprehensive approach provides valuable insights into a toddler’s overall development.

On the other hand, the Modified Checklist for Autism in Toddlers (M-CHAT) is a shorter screening tool that utilizes a series of yes/no questions. This streamlined format allows for quick and efficient identification of toddlers who may warrant further evaluation for ASD. Despite its brevity, the M-CHAT remains a valuable tool in the initial stages of ASD screening.

Unveiling the Findings: A Comparative Analysis


The May 2024 study involved researchers meticulously analyzing data from a group of 215 toddlers in Taiwan, aged between 18 and 29 months. Each toddler was assessed using both the full versions of the CBS and M-CHAT, alongside their respective shortened versions designed to enhance screening efficiency. Here’s a closer look at the key findings that emerged:

  • Effectiveness of Screening Tools: The study revealed that both the full CBS and M-CHAT demonstrated promising accuracy in identifying ASD in toddlers. This highlights the value of both tools in the early detection process. Interestingly, the shortened versions, CBS:9 critical items and M-CHAT:14 brief items, displayed even better performance compared to their full counterparts. This suggests that a more focused evaluation using a select set of key items might be sufficient for initial screening, potentially saving valuable time and resources.
  • CBS:9 – A Potential Advantage: The CBS:9 critical items version emerged as slightly more accurate than the full CBS in detecting ASD. This finding suggests that a targeted evaluation using a set of crucial CBS items might be sufficient for initial screening. Further research may be needed to validate this finding and establish clear guidelines for utilizing the CBS:9 effectively.
  • Combined Strength: Enhanced Identification: The study also emphasized the potential benefit of using both the CBS and M-CHAT together. When results from both tools were consistent, the identification of toddlers at high risk for ASD became more robust. This collaborative approach highlights the potential for improved accuracy when these screening tools are employed in tandem.
  • Age and ASD Scores: The research also indicated a noteworthy trend. Younger toddlers diagnosed with ASD tended to score higher on both the CBS and M-CHAT. This underlines the importance of early screening, particularly for toddlers exhibiting potential signs of ASD at a young age. Early intervention has the potential to significantly improve a child’s developmental trajectory.

The Road Ahead: Implications for Early Detection


The findings from this Taiwanese study offer valuable insights for pediatricians, psychologists, and other healthcare professionals involved in the early detection of ASD. Here’s a summary of the key takeaways:

  • Both the CBS and M-CHAT are valuable screening tools, each with its own strengths. The CBS provides a comprehensive assessment, while the M-CHAT offers a quick and efficient screening option.
  • Shortened versions of these tools can be efficient and accurate, potentially streamlining the screening process.
  • Combining these tools may improve the overall identification rate of toddlers at risk for ASD.
  • Early screening, especially for younger toddlers, is crucial for maximizing the effectiveness of intervention strategies.

It’s important to remember that this study was conducted in Taiwan, and further research is needed to confirm the generalizability of these findings across different populations. Additionally, neither the CBS nor M-CHAT is a definitive diagnostic tool for ASD. A comprehensive evaluation by a qualified professional is necessary for confirming an ASD diagnosis and developing an appropriate intervention plan.

Conclusion: Working Together for Early Intervention


Early detection of ASD is the cornerstone for optimizing intervention strategies and improving long-term outcomes for children. The May 2024 study highlights the promise of the CBS and M-CHAT, particularly their shortened versions (CBS:9 and M-CHAT:14), as valuable tools for early ASD screening in toddlers. By incorporating these tools into routine pediatric checkups and utilizing a collaborative approach that involves parents, healthcare professionals, and relevant specialists, early identification of children at risk for ASD becomes more robust. This collaborative effort can ensure timely access to evidence-based interventions, empowering children with ASD to reach their full potential and thrive throughout their lives.



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