# Validation of the online Toddler Autism and Development Adaptive Screener (TADAS) at 18 months

> **NIH NIH R44** · TOTAL CHILD HEALTH, INC. · 2021 · $250,263

## Abstract

Project Summary Abstract
The American Academy of Pediatrics has mandated identification of autism (ASD) beginning at the
routine 18-month visit, based on evidence that early intervention for children with autism improves
outcomes. However, the US Preventive Task Force has not endorsed that recommendation, in part
because of limited validity data. This study builds on a series of studies by our group aimed at
improving early autism identification. We have developed a promising novel and efficient screener for
primary care called Toddler Autism and Development Adaptive Screen (TADAS). The TADAS was
developed using machine learning to automatically determine which items to collect from the parent in
each case based on data from a community sample in a previous project. Currently used autism
screeners have high rates of missing children who have signs of ASD or Developmental Delay (DD) and
also problematic and costly rates of over-referral. Data from our prior studies showed that TADAS had
nearly three times the sensitivity (.94 vs .32) and similar specificity (.87 vs .90) to the currently
recommended and most popular screen for autism (M-CHAT-R/F) and more than twice the sensitivity
(.94 vs .39) and similar specificity (.79 vs .85) for developmental delay of the current standard Age &
Stages Questionnaire-3tm. The TADAS also provides greater efficiencies since a difficult-to-implement
recommended follow-up interview is not required and there is less parent burden in overall number of
items. This proposal is to program TADAS for online delivery then validate it against diagnostic testing
for ASD and DD in a new community sample of children coming for their 18-month well child visit that
better reflects the U.S. population in racial, ethnic and socioeconomic status than our original study
population. If our initial results are further validated in this study, screening for early ASD and DD
could be much more effective with corresponding improvements in child outcomes through earlier
intervention. A side benefit of the project will be an efficient Computer Adaptive Testing language
screen based on existing national language abilities data that could be used independently to both track
language impaired toddlers who are at risk for later development of autism as well as for general
language screening in primary care. These innovative new tools are being created within an online
clinical support system, called CHADIS that has additional features to assist in the entire process of
early identification, referral, and tracking. CHADIS provides individualized patient education for the
parent; clinician use of care coordination software connecting primary care with early intervention
services with options to share data and track outcomes; as well as options for doctors to receive
required Board re-certification credits for participating in autism screening quality improvement
efforts. The final product and “system of care” of value to clinicians, insurers, mu...

## Key facts

- **NIH application ID:** 10153564
- **Project number:** 1R44HD104973-01A1
- **Recipient organization:** TOTAL CHILD HEALTH, INC.
- **Principal Investigator:** Barbara Jo Howard
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $250,263
- **Award type:** 1
- **Project period:** 2021-09-14 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10153564

## Citation

> US National Institutes of Health, RePORTER application 10153564, Validation of the online Toddler Autism and Development Adaptive Screener (TADAS) at 18 months (1R44HD104973-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10153564. Licensed CC0.

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