Screening of toddlers at risk for autism spectrum disorder (ASD) in rural Dakshina Kannada, India, facilitated by accredited social health activists (ASHAs): a cross-sectional study

<h2>ABSTRACT</h2><h3>Objective</h3> The purpose of screening for autism spectrum disorder (ASD) in the present study was to address delayed ASD diagnosis in developing countries. Using community healthcare workers, namely, accredited social health activists (ASHAs), this study targeted the early screening of kids who may have a risk of developing ASD. <h3>Materials and methods</h3> This analytical cross-sectional investigation was conducted among toddlers of randomly chosen primary health centers in Dakshina Kannada District, Karnataka, India. ASHA workers, trained in the use of the translated (to the Kannada language) Modified Checklist for Autism in Toddlers (M-CHAT), conducted screenings to detect toddlers at risk of ASD. During their regular home visits, the ASHA workers completed the M-CHAT questionnaire as per the input from the parents. The investigators collected the data collected by ASHA workers and further subjected the data to statistical analysis. <h3>Results</h3> Fifty-eight ASHA workers from 6 PHCs completed 906 M-CHATs. According to the data analysis, six toddlers (0.7%) were found to have a high risk for ASD, and nearly half of the sample population (42.23%) belonged to the necessary follow-up category. There was no statistically significant relationship between sex and the total score calculated per M-CHAT. <h3>Conclusion</h3> Within the limitations, the study reported that 0.7% of the toddlers had a high risk for ASD, and 42.3% required follow-up when evaluated using the M-CHAT with the assistance of ASHA workers. By the end of the training, ASHA workers were well-equipped to contribute effectively to early screening of ASD during home visits.