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RISK ASSESSMENT OF AUTISM SPECTRUM DISORDER USING M-CHAT-R/F SCREENING TOOL AMONG TODDLERS ATTENDING PRIMARY HEALTH CARE IN JEDDAH, SAUDI ARABIA, 2018-2019: A ONE YEAR CROSS-SECTIONAL STUDY

Dr. Maryam Fairag, Dr. Zahra ALnajei, Dr. Nehad ALhazmi, Dr. Manahil Nouri

Background and Aims: There have been a movement of global increase in the occurrence of ASD. Early detection of ASD could lead to the best long-term prognosis of autism while late diagnosis is linked with bigger stress to guardians caused delayed intervention, which is critical to a child with ASD. In the Kingdom of Saudi Arabia, there is no standard screening tool being followed to detect autism cases as early as possible in primary health care. This study intends to explore the risk assessment and determinants of ASD among toddler children who are attending primary health care centers in Jeddah, Saudi Arabia. Materials and Methods: A cross sectional study was conducted to children ages 12-36 months attending at the PHC Centers affiliated to Ministry of Health in Jeddah City from 2018-2019. Characteristics of the child, socio-demographics and behavioral variables of both parents, and pregnancy and delivery related factors to ASD were identified using a defined and tested M-CHAT-R/F questionnaire. Chi-square test was used to check the relationship of the categorized variables with the significance threshold set at 5%. Results: Out of 900 respondents, a total of 891 qualified in the criteria. The study population has mean of current age of 23.7±5.6 months, mean age at which the child first word was 10.8±4.2 months, mean birth weight was 2.8±0.7. Females represent 52.5%, 69% were Saudi, 96% were full term baby, and 38% ranked as third or more birth order. Socio-demographic and behavioral characteristics of the parents has mean age of mothers and fathers were 30.7±6 and 35.4±7 years respectively, University level of education represents the highest percentage for both mothers (43.2%) and fathers (42.2%), however almost 80% of mothers were not working in the past 12 months. Before pregnancy, non-smoker mother were 95% and 59% of the fathers. The Arabic version of M-CHAT-R/F identified 762 (86.5%) of children were having a low risk of ASD, 102 (11.6%) were having a moderate risk, and the rest 17 (1.9%) (95% CI 1.02 to 2.84) were having a high risk. Chi-square test revealed three variables such as mother's smoking during pregnancy (p-value 0.01), mother smoking before pregnancy (p-value 0.042) and moral support during pregnancy (p-value 0.004) can predict ASD. Conclusion: Toddlers (12-36 months) attending primary health care in Jeddah, Saudi Arabia from 2018-2019 has 86.5% that fall under the low risk category, 11.6% have moderate risk and 1.9% (95% CI; 1.02 to 2.84) of the children having high risk of ASD. Mother's smoking before pregnancy and during pregnancy), and moral support during pregnancy were the identified significant predictors of ASD.

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