Risk Prediction using M-CHAT and Treatment with Speech and Occupational Therapy in Autism Spectrum Disorder
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Published:
Jun 17, 2025
Keywords:
autism, case report, diagnosis, screening, treatment
Main Article Content
Abstract
Introduction: Autism spectrum disorder (ASD) has been increasingly recognized, with the prevalence of ASD in 2017 in Indonesia was 0.36%. ASD is faced with challenges in detection and intervention, considering its new awareness initiated around 10-15 years ago.
Case Description: A 30-months-old male had a chief complaint of unable to form words. No other growth nor other pre-existing disorders were found. Denver II test found delay in speech and personal-social developments. M-CHAT found that the patient had a high risk of ASD. Behavioural Observational Therapy found no hearing disorders. The patient then received speech and occupational therapy, showing improvements in condition after 1 year of therapy.
Discussion: Diagnosing ASD must undergo several steps, which were development assessment, hearing assessment, ASD screening, and ASD diagnostic evaluation. Endorsed tools by the Ministry of Health of Indonesia for development screening were KPSP and Denver II test. Hearing assessment could be screened through TDD but should not undermine the need for equal distribution of hearing assessment tools, such as OAE and BERA. ASD screening was mainly done using M-CHAT, since other tools were less sensitive and specific. Diagnostic evaluation would be done according to DSM-5 criteria, which was more specific yet less sensitive than its predecessor. Other tests for development and ASD screening must be studied to provide alternatives. Regarding treatment, more studies were needed to provide deeper evidence for current therapies.
Conclusion: Further research in the screening, diagnosis, and treatment of ASD is needed.
Case Description: A 30-months-old male had a chief complaint of unable to form words. No other growth nor other pre-existing disorders were found. Denver II test found delay in speech and personal-social developments. M-CHAT found that the patient had a high risk of ASD. Behavioural Observational Therapy found no hearing disorders. The patient then received speech and occupational therapy, showing improvements in condition after 1 year of therapy.
Discussion: Diagnosing ASD must undergo several steps, which were development assessment, hearing assessment, ASD screening, and ASD diagnostic evaluation. Endorsed tools by the Ministry of Health of Indonesia for development screening were KPSP and Denver II test. Hearing assessment could be screened through TDD but should not undermine the need for equal distribution of hearing assessment tools, such as OAE and BERA. ASD screening was mainly done using M-CHAT, since other tools were less sensitive and specific. Diagnostic evaluation would be done according to DSM-5 criteria, which was more specific yet less sensitive than its predecessor. Other tests for development and ASD screening must be studied to provide alternatives. Regarding treatment, more studies were needed to provide deeper evidence for current therapies.
Conclusion: Further research in the screening, diagnosis, and treatment of ASD is needed.
Article Details
How to Cite
Sudarmanto, A. M., Rahmatika, & Kurnia, M. F. (2025). Risk Prediction using M-CHAT and Treatment with Speech and Occupational Therapy in Autism Spectrum Disorder. Indonesian Journal of Physical Medicine and Rehabilitation, 14(1), 92 - 104. https://doi.org/10.36803/indojpmr.v14i1.425
Section
Case Report
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17. Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, et al. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord. 2022 Dec 4;52(12):5308–20. https://doi.org/10.1007/s10803-021-05377-y
18. Mandy W, Charman T, Puura K, Skuse D. Investigating the cross-cultural validity of DSM-5 autism spectrum disorder: Evidence from Finnish and UK samples. Autism. 2014 Jan 10;18(1):45–54. https://doi.org/10.1177/1362361313508026
19. Zhao S, Chen W, Dhar SU, Eble TN, Kwok O, Chen L. Pursuing genetic testing for children with autism spectrum disorders: What do parents think? J Genet Couns. 2021 Apr 28;30(2):370–82. https://doi.org/10.1002/jgc4.1320
20. Ozsahin I, Mustapha MT, Albarwary S, Sanlidag B, Ozsahin DU, Butler TA. An investigation to choose the proper therapy technique in the management of autism spectrum disorder. J Comp Eff Res. 2021 Apr;10(5):423–37. https://doi.org/10.2217/cer-2020-0162
21. Chaware S, Dubey S, Kakatkar V, Jankar A, Pustake S, Darekar A. The systematic review and meta-analysis of oral sensory challenges in children and adolescents with autism spectrum disorder. J Int Soc Prev Community Dent. 2021;11(5):469. https://doi.org/10.4103%2Fjispcd.JISPCD_135_21
22. Hemati Alamdarloo G, Mradi H. The effectiveness of sensory integration intervention on the emotional-behavioral problems of children with autism spectrum disorder. Advances in Autism. 2021 May 12;7(2):152–66. https://doi.org/10.1108/AIA-12-2019-0051
23. Schoen SA, Lane SJ, Mailloux Z, May‐Benson T, Parham LD, Smith Roley S, et al. A systematic review of ayres sensory integration intervention for children with autism. Autism Research. 2019 Jan 12;12(1):6–19. https://doi.org/10.1002/aur.2046
24. Raditha C, Handryastuti S, Pusponegoro HD, Mangunatmadja I. Positive behavioral effect of sensory integration intervention in young children with autism spectrum disorder. Pediatr Res. 2023 May 27;93(6):1667–71. https://doi.org/10.1038/s41390-022-02277-4
2. Saloko E, Harumi L, Sumaryanto E, Kobayashi R, Ito Y. Plotting current practices and challenges among Indonesian occupational therapists working with individuals with autism spectrum disorders. World Federation of Occupational Therapists Bulletin. 2021 Jul 3;77(2):93–101. https://doi.org/10.1080/14473828.2021.1938863
3. Khoirunisa E, Karsidi R, Yusuf M. The Role of Posyandu as Primary Health Care Services in Implementing Early Detection and Intervention for Autistic Children in Indonesia. International Journal of Multicultural and Multireligious Understanding. 2019 Feb 1;6(1):101. http://dx.doi.org/10.18415/ijmmu.v6i1.511
4. Badan Pusat Statistik. Statistik Indonesia 2023. Jakarta: Badan Pusat Statistik; 2023.
5. Larasati MD, Qolbi PA, Fatimah RS. Deteksi Penyimpangan Tumbuh Kembang Balita dengan Peningkatan Pengetahuan Ibu dan Penggunaan Kuesioner Pra Skrining Perkembangan. PUNDIMAS: Publikasi Kegiatan Abdimas. 2022 Sep 15;1(3):150–63. https://doi.org/10.37010/pnd.v1i3.1135
6. Elfira D, Ramadhanti P, Ningsih SA, Khadijah K. Deteksi Tumbuh Kembang Anak Menggunakan KPSP. Jurnal Pendidikan dan Konseling. 2022 Jun 30;4(3). https://doi.org/10.31004/jpdk.v4i3.5126
7. Yuwono J, Gunarhadi G, Yusuf M, Supratiwi M, Shahbodin F, Nuraini CK. Measuring Teachers’ Knowledge and Skills in Identification of Children with Autism in Elementary Schools. In: ICLIQE 2021: Proceeding of The 5th International Conference on Learning Innovation and Quality Education. New York, NY, USA: ACM; 2021. p. 1–8. https://doi.org/10.1145/3516875.3516976
8. Entoh C, Noya F, Ramadhan K. Deteksi Perkembangan Anak Usia 3 Bulan – 72 Bulan Menggunakan Kuesioner Pra Skrining Perkembangan (KPSP). Poltekita: Jurnal Pengabdian Masyarakat. 2020 May 18;1(1):8–14. https://doi.org/10.33860/pjpm.v1i1.72
9. Hamdanesti R, Oresti S. The Effectiveness of Comparison of the Use of the Kuesioner Pra Skrining Perkembangan (KPSP) with Denver II on Development Children aged 0 – 72 months in the Dadok Primary Health Center Work Padang. Jurnal Ilmiah Ilmu Keperawatan Indonesia. 2021 Dec 28;11(04):207–13. https://doi.org/10.33221/jiiki.v11i04.1532
10. Fischer VJ, Morris J, Martines J. Developmental screening tools: feasibility of use at primary healthcare level in low- and middle-income settings. J Health Popul Nutr. 2014 Jun;32(2):314–26. PMID: 25076668; PMCID: PMC4216967.
11. Nursasmita R. GAMBARAN PERKEMBANGAN ANAK USIA PRA SEKOLAH MENGGUNAKAN METODE KUESIONER PRA SKRINING PERKEMBANGAN (KPSP). Jurnal Keperawatan dan Kesehatan Penerbangan. 2022 Feb;1(2). https://ejournal.akper-rspau.ac.id/index.php/JKKP/article/view/14
12. Artha NM, Sutomo R, Gamayanti IL. Kesepakatan hasil antara kuesioner pra skrining perkembangan, parentâ€TM s evaluation of developmental status, dan tes Denver-II untuk skrining perkembangan anak balita. Sari Pediatri. 2016;16(4):266–70. http://dx.doi.org/10.14238/sp16.4.2014.266-70
13. Kementerian Kesehatan RI. Pedoman Pelaksanaan Stimulasi, Deteksi dan Intervensi Dini Tumbuh Kembang Anak di Tingkat Pelayanan Kesehatan Dasar. Jakarta: Kementerian Kesehatan RI; 2016. 1–59 p.
14. Wroblewska-Seniuk KE, Dabrowski P, Szyfter W, Mazela J. Universal newborn hearing screening: methods and results, obstacles, and benefits. Pediatr Res. 2017 Mar 18;81(3):415–22. https://doi.org/10.1038/pr.2016.250
15. Hyman SL, Levy SE, Myers SM, Kuo DZ, Apkon S, Davidson LF, et al. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020 Jan 1;145(1). https://doi.org/10.1542/peds.2019-3447
16. Wiggins LD, Rice CE, Barger B, Soke GN, Lee LC, Moody E, et al. DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children. Soc Psychiatry Psychiatr Epidemiol. 2019 Jun 8;54(6):693–701. https://doi.org/10.1007/s00127-019-01674-1
17. Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, et al. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord. 2022 Dec 4;52(12):5308–20. https://doi.org/10.1007/s10803-021-05377-y
18. Mandy W, Charman T, Puura K, Skuse D. Investigating the cross-cultural validity of DSM-5 autism spectrum disorder: Evidence from Finnish and UK samples. Autism. 2014 Jan 10;18(1):45–54. https://doi.org/10.1177/1362361313508026
19. Zhao S, Chen W, Dhar SU, Eble TN, Kwok O, Chen L. Pursuing genetic testing for children with autism spectrum disorders: What do parents think? J Genet Couns. 2021 Apr 28;30(2):370–82. https://doi.org/10.1002/jgc4.1320
20. Ozsahin I, Mustapha MT, Albarwary S, Sanlidag B, Ozsahin DU, Butler TA. An investigation to choose the proper therapy technique in the management of autism spectrum disorder. J Comp Eff Res. 2021 Apr;10(5):423–37. https://doi.org/10.2217/cer-2020-0162
21. Chaware S, Dubey S, Kakatkar V, Jankar A, Pustake S, Darekar A. The systematic review and meta-analysis of oral sensory challenges in children and adolescents with autism spectrum disorder. J Int Soc Prev Community Dent. 2021;11(5):469. https://doi.org/10.4103%2Fjispcd.JISPCD_135_21
22. Hemati Alamdarloo G, Mradi H. The effectiveness of sensory integration intervention on the emotional-behavioral problems of children with autism spectrum disorder. Advances in Autism. 2021 May 12;7(2):152–66. https://doi.org/10.1108/AIA-12-2019-0051
23. Schoen SA, Lane SJ, Mailloux Z, May‐Benson T, Parham LD, Smith Roley S, et al. A systematic review of ayres sensory integration intervention for children with autism. Autism Research. 2019 Jan 12;12(1):6–19. https://doi.org/10.1002/aur.2046
24. Raditha C, Handryastuti S, Pusponegoro HD, Mangunatmadja I. Positive behavioral effect of sensory integration intervention in young children with autism spectrum disorder. Pediatr Res. 2023 May 27;93(6):1667–71. https://doi.org/10.1038/s41390-022-02277-4