Browsing by Author "Czabanowska, Katarzyna"

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    Bayesian prevalence of autism and unmet special education needs in Chile in a sample of three million school-age children
    (2025) Román Urrestarazú, Andrés; Tyson, Adele; Gatica Bahamondes, Gabriel Guillermo; Kessel, Robin van; Yang, Justin; Mansilla, Carola; Zúñiga, Isabel; Méndez-Fadol, Alejandra; Larraín, Blanca; García, Ricardo; Koch, Damaris; Ford, Tamsin; Groot, Wim; Pavlova, Milena; Czabanowska, Katarzyna
    Autism spectrum disorder prevalence estimates in Latin America have been limited by a lack of reliable data. This cohort study aimed to estimate autism spectrum disorder prevalence in Chile by linking school registries with electronic health records. Probabilistic data linking was conducted between the 2021 Chilean school registry and 2003−2015 health records from the Araucania Sur Health Service. Bayesian prevalence estimation was used, considering variables such as age, sex, immigration status, ethnicity and rurality. Autism spectrum disorder prevalence across 29 health services was analysed for students aged 6 to 18 years. Regression models assessed unmet needs for special education services, validated using Araucania Sur Health Service health records. The study included 3,056,306 pupils (51.34% boys; mean age 11.6 years), with 14,549 having autism spectrum disorder. The national standardized school prevalence was 0.46%. Boys had 6 times higher odds of receiving special education services support than girls. In Araucania Sur Health Service, the adjusted clinical prevalence from health records was 1.22%. The Bayesian projected national autism spectrum disorder prevalence was 1.31%. This study, the largest of its kind in Latin America, revealed a higher autism spectrum disorder prevalence than previously reported, with one in 76 children affected. Disparities were observed across sex, ethnicity and health services.
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    Testing an online screening for autism in the COVID-19 pandemic: a psychometric study of the Q-CHAT-24 in Chilean toddlers
    (FRONTIERS MEDIA SA, 2024) Gatica Bahamondes, Gabriel Guillermo; Mendez Fadol, Alejandra; Sanchez Sepulveda, Francisca; Penailillo Diaz, Constanza; van Kessel, Robin; Czabanowska, Katarzyna; Roman Urrestarazu, Andrés
    Background: The aim of this study was to examine some psychometric characteristics of the Chilean-adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-24) (24) in a group of unselected children (community sample). This version was administered remotely through an online version during the pandemic period to caregivers of children, aged 18-24 months, registered in four primary care polyclinics of the Health Service Araucan & iacute;a Sur, Chile. Methods: An intentional non-probabilistic sampling was used. Three hundred and thirteen toddlers were examined. Participants completed an online version of the Q-CHAT-24 which was disseminated through the REDCap platform. Evidence of reliability through internal consistency and evidence of predictive validity through ROC curve analysis were realized. Results: The mean age of the children evaluated was 21.16 months. The Shapiro-Wilk test revealed that Q-CHAT-24 scores was normally distributed. 71 cases (23.12%) scored 38 points or more on the Q-CHAT-24, qualifying as Autistic Risk. 48 cases (15.63%) were confirmed as autistic through the ADOS-2 Module T. All items were positively correlated with Q-CHAT-24 total score. All items were positively correlated with Q-CHAT-24 total score. Internal consistency was acceptable for the Q-CHAT-24 (Cronbach s alpha=0.78). The internal consistencies were analyzed for the Q-CHAT-24 Factors, and they were good for factor 1 "Communication and Social Interaction" (Cronbach s alpha=0.85) and acceptable for factor 2 "Restrictive and Repetitive Patterns" (Cronbach s alpha=0.74). Receiver operating characteristic (ROC) curve analyses were performed. The AUC values were 0.93 with statistical significance (p<0.01). For the cut-off point of 38, the Sensitivity, Specificity and Youden index values were 0.89, 0.8 and 0.7, respectively. The Positive Predictive Value (PPV) was 86% and the Negative Predictive Value (NPV) was 85%. Conclusions: In accordance with the objectives of this study, evidence of reliability and predictive validity was demonstrated for the Q-CHAT-24 in this Chilean population. More importantly, this study provides Sensitivity and Specificity data for a remote application version of an autism screening tool already validated in Chile. The implications of this have to do with the possibility of establishing a remote assessment system for children at risk of autism on a population scale.