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Investigating the predictive validity of the quantitative checklist for autism in toddlers and the autism diagnostic observation schedule-2 in children at elevated likelihood for autism

Sarah Schaubroeck (UGent) , Ellen Demurie (UGent) , Jannath Begum-Ali, Sven Bolte, Sofie Boterberg (UGent) , Jan Buitelaar, Tony Charman, Terje Falck-Ytter, Sabine Hunnius, Mark Johnson, et al.
(2026) JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS. 56(2). p.633-647
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Abstract
This study examined the recurrence rate of autism in siblings at elevated likelihood (EL) and the predictive validity of the Q-CHAT and ADOS-2 at 14 and 24 months (m) for a clinical best estimate (CBE) autism diagnosis at 3 years. 331 EL-siblings (47.9% girls) from the prospective longitudinal EuroSibs study underwent ADOS-2 assessments and caregivers completed the Q-CHAT at 14 m and 24 m. At 3 years CBE was determined using DSM-5 criteria. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated. Autism recurrence rate was 25.7% [95% CI (21.1, 30.6)]. Q-CHAT sensitivity was 31.8% [95% CI (21.4, 43.6)] at 14 m and 30.6% [95% CI (20.7, 41.7)] at 24 m. Specificity was 81.2% [95% CI (75.4, 86.2)] at 14 m and 94.8% [95% CI (91.2, 97.2)] at 24 m. PPV was 35.6% [95% CI (24.2, 48.2)] at 14 m and 66.7% [95% CI (49.8, 81.1)] at 24 m. NPV was 78.5% [95% CI (72.6, 83.7)] and 79.9% [95% CI (74.7, 84.6)] respectively. ADOS-2 demonstrated a of 64.3% [95% CI (45.9, 80.2)] and 69.3% [95% CI (58.4, 79.0)] and a specificity of 71.1% [95% CI (60.3, 80.4)] and 68.7% [95% CI (62.5, 74.5)] at 14 m and 24 m respectively. PPV was 45% [95% CI (30.3, 60.4)] at 14 m and 41.9% [95% CI (33.5, 50.7)] at 24 m. NPV was 84.4% [95% CI (74.2, 91.8)] at 14 m and 87.3% [95% CI (81.9, 91.6)] at 24 m. Q-CHAT and ADOS-2 at 14 m and 24 m can aid in early differentiation between EL-siblings who need further assessment and those who do not, but neither has sufficient sensitivity and PPV for standalone CBE diagnosis prediction.
Keywords
ADOS-2, Q-CHAT, Siblings, Elevated likelihood, Autism, Early screening, SPECTRUM DISORDER, YOUNG-CHILDREN, HIGH-RISK, SCREENING INSTRUMENTS, M-CHAT, SIBLINGS, STABILITY, AGE, IDENTIFICATION, VALIDATION

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MLA
Schaubroeck, Sarah, et al. “Investigating the Predictive Validity of the Quantitative Checklist for Autism in Toddlers and the Autism Diagnostic Observation Schedule-2 in Children at Elevated Likelihood for Autism.” JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS, vol. 56, no. 2, 2026, pp. 633–47, doi:10.1007/s10803-024-06585-y.
APA
Schaubroeck, S., Demurie, E., Begum-Ali, J., Bolte, S., Boterberg, S., Buitelaar, J., … Roeyers, H. (2026). Investigating the predictive validity of the quantitative checklist for autism in toddlers and the autism diagnostic observation schedule-2 in children at elevated likelihood for autism. JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS, 56(2), 633–647. https://doi.org/10.1007/s10803-024-06585-y
Chicago author-date
Schaubroeck, Sarah, Ellen Demurie, Jannath Begum-Ali, Sven Bolte, Sofie Boterberg, Jan Buitelaar, Tony Charman, et al. 2026. “Investigating the Predictive Validity of the Quantitative Checklist for Autism in Toddlers and the Autism Diagnostic Observation Schedule-2 in Children at Elevated Likelihood for Autism.” JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 56 (2): 633–47. https://doi.org/10.1007/s10803-024-06585-y.
Chicago author-date (all authors)
Schaubroeck, Sarah, Ellen Demurie, Jannath Begum-Ali, Sven Bolte, Sofie Boterberg, Jan Buitelaar, Tony Charman, Terje Falck-Ytter, Sabine Hunnius, Mark Johnson, Emily Jones, Greg Pasco, Carlijn Van den Boomen, Petra Warreyn, and Herbert Roeyers. 2026. “Investigating the Predictive Validity of the Quantitative Checklist for Autism in Toddlers and the Autism Diagnostic Observation Schedule-2 in Children at Elevated Likelihood for Autism.” JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 56 (2): 633–647. doi:10.1007/s10803-024-06585-y.
Vancouver
1.
Schaubroeck S, Demurie E, Begum-Ali J, Bolte S, Boterberg S, Buitelaar J, et al. Investigating the predictive validity of the quantitative checklist for autism in toddlers and the autism diagnostic observation schedule-2 in children at elevated likelihood for autism. JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS. 2026;56(2):633–47.
IEEE
[1]
S. Schaubroeck et al., “Investigating the predictive validity of the quantitative checklist for autism in toddlers and the autism diagnostic observation schedule-2 in children at elevated likelihood for autism,” JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS, vol. 56, no. 2, pp. 633–647, 2026.
@article{01JDHNTG2YH83H3YH31RYC9A04,
  abstract     = {{This study examined the recurrence rate of autism in siblings at elevated likelihood (EL) and the predictive validity of the Q-CHAT and ADOS-2 at 14 and 24 months (m) for a clinical best estimate (CBE) autism diagnosis at 3 years. 331 EL-siblings (47.9% girls) from the prospective longitudinal EuroSibs study underwent ADOS-2 assessments and caregivers completed the Q-CHAT at 14 m and 24 m. At 3 years CBE was determined using DSM-5 criteria. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated. Autism recurrence rate was 25.7% [95% CI (21.1, 30.6)]. Q-CHAT sensitivity was 31.8% [95% CI (21.4, 43.6)] at 14 m and 30.6% [95% CI (20.7, 41.7)] at 24 m. Specificity was 81.2% [95% CI (75.4, 86.2)] at 14 m and 94.8% [95% CI (91.2, 97.2)] at 24 m. PPV was 35.6% [95% CI (24.2, 48.2)] at 14 m and 66.7% [95% CI (49.8, 81.1)] at 24 m. NPV was 78.5% [95% CI (72.6, 83.7)] and 79.9% [95% CI (74.7, 84.6)] respectively. ADOS-2 demonstrated a of 64.3% [95% CI (45.9, 80.2)] and 69.3% [95% CI (58.4, 79.0)] and a specificity of 71.1% [95% CI (60.3, 80.4)] and 68.7% [95% CI (62.5, 74.5)] at 14 m and 24 m respectively. PPV was 45% [95% CI (30.3, 60.4)] at 14 m and 41.9% [95% CI (33.5, 50.7)] at 24 m. NPV was 84.4% [95% CI (74.2, 91.8)] at 14 m and 87.3% [95% CI (81.9, 91.6)] at 24 m. Q-CHAT and ADOS-2 at 14 m and 24 m can aid in early differentiation between EL-siblings who need further assessment and those who do not, but neither has sufficient sensitivity and PPV for standalone CBE diagnosis prediction.}},
  author       = {{Schaubroeck, Sarah and Demurie, Ellen and Begum-Ali, Jannath and Bolte, Sven and Boterberg, Sofie and Buitelaar, Jan and Charman, Tony and Falck-Ytter, Terje and Hunnius, Sabine and Johnson, Mark and Jones, Emily and Pasco, Greg and Van den Boomen, Carlijn and Warreyn, Petra and Roeyers, Herbert}},
  issn         = {{0162-3257}},
  journal      = {{JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS}},
  keywords     = {{ADOS-2,Q-CHAT,Siblings,Elevated likelihood,Autism,Early screening,SPECTRUM DISORDER,YOUNG-CHILDREN,HIGH-RISK,SCREENING INSTRUMENTS,M-CHAT,SIBLINGS,STABILITY,AGE,IDENTIFICATION,VALIDATION}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{633--647}},
  title        = {{Investigating the predictive validity of the quantitative checklist for autism in toddlers and the autism diagnostic observation schedule-2 in children at elevated likelihood for autism}},
  url          = {{http://doi.org/10.1007/s10803-024-06585-y}},
  volume       = {{56}},
  year         = {{2026}},
}
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