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measures of the three screening instruments and the CHAT-key-items for the total group and for two age groups separately
Source publication
Several instruments have been developed to screen for autism spectrum disorders (ASD) in high-risk populations. However, few studies compare different instruments in one sample. Data were gathered from the Early Screening of Autistic Traits Questionnaire, Social Communication Questionnaire, Communication and Symbolic Behavior Scales-Developmental P...
Contexts in source publication
Context 1
... various indices of diagnostic accuracy of the different screening instruments are summarized in Table 4 for the total age group and for two different age groups separately. ...Context 2
... excellent. Applying these cri- teria to the results in Table 4, not a single screening instrument, at the whole age range, or for the younger and older subgroups, demonstrated acceptable diagnostic accuracy for all four indices (Se, Sp, NPV, PPV). In fact, the most that occurred is that only two of the indices meet the 0.70 minimum. ...Similar publications
Background:
People with autism spectrum disorder (ASD) commonly experience symptoms related to attention-deficit/hyperactivity disorder (ADHD), including hyperactivity, inattention, and impulsivity. One-third of ASD cases may be complicated by the presence of ADHD. Individuals with dual diagnoses face greater barriers to accessing treatment for AD...
Citations
... It has been suggested in previous studies to lower the conventional SCQ-L cut-off point of 15 when screening the general school population [27]. Some studies propose using a lower cut-off point of 11 [3,17,29,40] or 12 [11] to improve sensitivity and reduce the likelihood of false negatives. ...
Background
This nationwide study aimed to estimate Autism Spectrum Disorder (ASD) prevalence in 7–9-year-old Italian children. Promoted by Italy's Ministry of Health and coordinated by the National Observatory for Autism at the National Institute of Health, it covered schools in northern (Lecco and Monza-Brianza), central (Rome and its province), and southern (Palermo and its province) regions from February 24, 2016, to February 23, 2018, using a multi-stage approach defined by the European Union's ASD network.
Methods
Phase one identified ASD-diagnosed children in mainstream schools through local Ministry of Education (MoE) disability registries. Phase two had a subset of schools screen 7–9-year-olds using the Social Communication Questionnaire-Life version (SCQ-L). Those with SCQ-L scores of 15 + underwent clinical consultation for ASD symptoms, cognitive abilities, and life skills. To counter potential false negatives, 20% scoring 11–14 were randomly assessed via Autism Diagnostic Interview-Revised (ADI-R).
Results
MoE data revealed 9.8 per 1000 certified ASD children in the north, 12.2 in the central, and 10.3 in the south. In phase two, 35,823 SCQ-L questionnaires were distributed across 198 schools (northern: 11,190 in 49 schools, central: 13,628 in 87 schools, southern: 11,005 in 62 schools). Of SCQ-L respondents, 2.4% (n = 390) scored above the 15 cutoff. Among these, 100 had ASD diagnoses, and 50 had other diagnoses. Among 115 families assessed, 16.5% (n = 19) received ASD diagnoses.
Conclusions
The estimated prevalence of ASD in Italy was 13.4 (11.3–16.0) per 1,000 children aged 7–9 years, with a male-to-female ratio of 4.4:1. It will guide national policies in enhancing services tailored to the specific needs of autistic children.
... The CSBS DP ITC was found to have the highest sensitivity for autism spectrum disorder in high-risk toddlers among other screening tools, particularly for children aged 24 months or younger (Oosterling et al., 2009). High-risk infants can be categorized according to sociodemographic risk factors, maternal medical history, and child medical history (Kliegman et al., 2016;Soedjatmiko, 2016). ...
The Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP) is a valid and reliable screening tool for detecting language delay in children. However, it has not been translated into the Indonesian language. This study aimed to determine the validity and internal consistency of the Indonesian-translated CSBS DP as a screening tool for language delay in children aged 6–24 months. A cross-sectional study was carried out at the Growth and Development Clinic, Cipto Mangunkusumo Hospital, in 3 stages: (1) transcultural translation and adaptation of the measure into the Indonesian language; (2) determination of the internal consistency of the measure; and (3) determination of the concurrent validity of the measure by comparing CSBS DP with the Bayley Scales of Infant and Toddler Development, third edition (BSID-III) language scale on 149 caregivers–children dyads. We found good concurrent validity ( r > .3) and good internal consistency with Cronbach's α values of 0.876–0.896. The concurrent validity of the Indonesian-translated questionnaire showed a sensitivity of 71.43% and a specificity of 81.48%. CSBS DP Indonesian-translated questionnaire is a valid and reliable screening test for language delay in children aged 6–24 months.
... Por este motivo, se recomienda aplicar distintos instrumentos en forma seriada a lo largo de la infancia (figura 1). Si bien al aplicar cuestionarios seriados se corre el riesgo de pesquisar niños con resultados falsamente positivos, se ha visto que muchos de estos niños tienen alguna DD que es necesaria atender en forma oportuna 70,71 . Por otro lado, en el TEA es habitual encontrar variadas comorbilidades en distintas áreas del desarrollo y el comportamiento, que igualmente requerirán de algún tipo de intervención precoz 8,39 . ...
La pesquisa y derivación temprana del trastorno del espectro autista (TEA) son claves para potenciar el desarrollo de los niños afectados. Recientemente se promulgó una ley que indica realizar tamizaje de TEA en las prestaciones de salud. Esto representa un desafío para los profesionales de pediatría ambulatoria. El objetivo es revisar la utilidad en el tamizaje de TEA, de cuestionarios y escalas validadas en Chile para el screening del desarrollo psicomotor, desarrollo socio-emocional y cribado específico de TEA. El screening del desarrollo psicomotor evalúa el desempeño general desde edades tempranas, dando las primeras señales de retraso, con mayor probabilidad de que se trate de TEA si hay compromiso de los dominios social y lenguaje. Los cuestionarios socio-emocionales pueden ser aplicados precozmente, entre sus ítems se incorporaron preguntas de señales de TEA, pero no se usan rutinariamente en atención pediátrica. Las escalas específicas de screening de TEA validadas en Chile son Cuestionario Modificado de Detección del Autismo en Niños y Niñas Pequeños (M-CHAT), Quantitative Checklist for Autism in Toddlers Q-CHAT (Q-CHAT) y el Examen del Estado Mental para Autismo (AMSE), para lactantes mayores de 15/18 meses, con propiedades psicométricas prometedoras. Se recomienda complementar la observación clínica con pruebas generales para el tamizaje del desarrollo psicomotor, desarrollo socio-emocional y escalas específicas para el screening de TEA, en forma seriada en la infancia. La implementación de cuestionarios en línea permite optimiza su cobertura e interpretación. Independiente del dominio afectado, es importante realizar un seguimiento y comenzar con intervención temprana, mientras se realiza la confirmación diagnóstica.
... Para isso, instrumentos e técnicas de rastreio de segundo nível são desenvolvidos para serem utilizados em populações de alto risco, ou seja, que já apresentam sinais de atrasos desenvolvimentais. (Johnson et al., 2007;Oosterling et al., 2009). ...
Identification of signs of ASD and diagnosis require the use of tests with diverse sources of validity evidence. The aim of this study was to gather validity evidence for the PROTEA-R-NV based on: a) criteria variables and b) convergent validity with the M-CHAT. A mixed method design was performed (comparative and correlational groups). In the comparative analysis, 15 children diagnosed with ASD (mean age 44.8 (SD=16.64) months) and 15 children without this diagnosis (mean age 45.13 (SD=17.62) months) participated. Participants in the correlational analysis were 44 children with and without ASD (mean age 45.10(SD=15.90) months). The majority of PROTEA-R-NV items and the total score of the critical items showed significant differences between groups, with the ASD group presenting higher scores, indicating more impairment. The M-CHAT total score showed strong and positive correlation with the PROTEA-R-NV critical items score. Accordingly, the PROTEA-R-NV presented adequate evidence of validity based on criteria and convergent validity.
... 46 Non-verbal children have also been shown to score higher on the SCQ despite the fact that they have no data for six items that are strictly applicable to verbal children. 47,48 One explanation given for this finding is that non-verbal children may show more severe features of ASD compared with their verbal counterparts. 48 This study also showed a significant association between delay in milestones and ASD symptoms. ...
... 47,48 One explanation given for this finding is that non-verbal children may show more severe features of ASD compared with their verbal counterparts. 48 This study also showed a significant association between delay in milestones and ASD symptoms. This has been noted before in another study that reported delays in motor milestones in children with ASD compared with normal children. ...
Background: Children with neurological disorders are more likely to present with autism spectrum disorder (ASD) symptoms and get an ASD diagnosis. Despite the large burden of childhood neurological disorders in Uganda, there is limited information on ASD amongst children with neurological disorders in Uganda.
Aim: The aim of this study was to determine the prevalence and factors associated with ASD symptoms amongst children attending the paediatric neurology clinic.
Setting: The study was conducted at the paediatric neurology clinic of Mulago National Referral Hospital in Uganda.
Methods: This was a cross-sectional study of 318 children aged 2–9 years. After obtaining consent, a socio-demographic questionnaire and the Social Communication Questionnaire were administered to the caregivers of the children. Additional questions were administered to assess the prenatal, birth and postnatal characteristics of the children. Sample characteristics were described using frequencies and means. Bivariate analysis was carried out using chi-square test and Fisher’s exact test. Multiple logistic regression models were used to assess which factors were independently associated with ASD symptoms.
Results: The mean age of the children was 5 years and 58.2% were males. The prevalence of significant ASD symptoms was found to be 45%. Factors negatively associated with significant ASD symptoms were female sex (odds ratio [OR] 0.48 [95% CI 0.24, 0.98]) and ability to speak (OR 0.09 [95% CI 0.04, 0.2]). The history of delayed developmental milestones was positively associated with significant ASD symptoms (OR 3.3 [95% CI 1.59, 6.84]).
Conclusion: The prevalence of ASD symptoms is high in children with neurological disorders. Children, especially those with delayed developmental milestones, should routinely be screened for ASD.
... Early detection and intervention of ASD are important factors for improving the prognosis (Vivanti et al. 2016). However, early detection before the age of 2 is difficult with available screening tools (Oosterling et al. 2009). Therefore, an examination by an experienced healthcare professional is required for accurate screening of ASD. ...
The present study aimed to identify the cumulative incidence of autism spectrum disorder (ASD) in a thoroughly screened population and to examine the behavioral and motor characteristics observed in children with ASD at the age of 18 months. Subjects were 1067 children who underwent a screening assessment for ASD at the routine 18-months health checkup. By the age of 6 years, 3.1% (4.3% of boys and 2.0% of girls) were diagnosed as having ASD by their attending pediatricians. Higher rate of difficulties in motor skills and social and communication skills had been reported in children with ASD at 18 months of age. This study showed that careful community-based screening system may be helpful in detecting ASD at early age.
... Screening tools are of great interest to mental health professionals to assist in identifying at-risk youth. In a study comparing different screening instruments in more than 200 children, many screening measures failed to obtain the level of sensitivity and specificity needed to distinguish children with ASD from at-risk children with other developmental difficulties who did not have an ASD diagnosis (Osterling et al., 2009). In fact, Osterling and colleagues (2009) suggest that no individual test item or assessment instrument thus far has shown adequate power in discriminating children with ASD from those with a non-ASD diagnosis. ...
... Based on previous research (e.g., Ghuman et al., 1998aGhuman et al., , 1998bGhuman et al., , 2011Osterling et al., 2009), we hypothesized that social interaction deficits as measured by the GF-SSI would significantly predict (p < 0.05) the probability of identifying children with a diagnosis of ASDs in a sample of clinically referred high-risk children between 24 and 60 months-of-age who have previously been diagnosed as having either an ASDs or another developmental and/or psychiatric disorder. ...
... In this regard, a strong bivariate relationship was found between GF-SSI and ASD prior to the binary logistic regression analyses. As few screening measures currently exist with the level of sensitivity and specificity needed to distinguish children with ASD from children with abnormal development (Osterling et al., 2009), the GF-SSI is indicated to be a strong predictor for ASD and may be a useful screening tool to discriminate between children with ASD versus children with PDD-NOS and other clinical diagnoses ages 2 to 6 years old. ...
... Parent-mediated interventions for core symptoms of ASD have been an area of active research. Although the available ASD-specific screening tools are beneficial in identifying ASD, they are still limited in identifying young children with ASD, as well as indiscriminate ASD from other developmental disorders [33,34]. Therefore, having a brief, formal, standardized, and accurate screening instrument to identify children with ASD, regardless of their age, will profoundly impact their entire life journey; furthermore, it will relieve the parents and professionals. ...
... Following removal of 42 duplicates, 848 of the 907 unique references were excluded after reviewing their title and abstract because they either did not appear to be studies validating ASD screening tools or because they did not compare the screening tool to the ADOS or the ADI-R. Of the remaining 59 studies, 44 were excluded after full text review for the following reasons: 1 study was a review article (Robins & Dumont-Mathieu, 2006), 6 studies were conducted for identifying ASD prevalence but not for the validation of screening tools (Bryson, Bradley, Thompson, & Wainwright, 2008;Constantino et al., 2003;Lee et al., 2010;Mattila et al., 2011;Pine, Luby, Abbacchi, & Constantino, 2006;Wiggins, Piazza, & Robins, 2014), 11 studies were conducted to examine the validation of screening tools, but no gold-standard diagnostic tools were used (Eaves, Wingert, Ho, & Mickelson, 2006;Ehlers et al., 1999;Mohammadian, Zarafshan, Mohammadi, & Karimi, 2015;Murray, Mayes, & Smith, 2011;Oliveira et al., 2007;Posserud, Lundervold, & Gillberg, 2009;Robins, Fein, Barton, & Green, 2001;Saemundsen et al., 2010;Sizoo et al., 2015;Skuse et al., 2005;Woodbury-Smith, Robinson, Wheelwright, & Baron-Cohen, 2005), 1 study was conducted for the validation of a screening tool, but only limited number of participants underwent gold standard diagnostic tools (Sappok, Diefenbacher, Gaul, & Bölte, 2015), 4 studies included no reports of any of Se, Sp, PPV, or NPV, and information was not provided by authors upon request despite the fact that the studies otherwise met inclusion criteria Baird et al., 2006;de Bildt et al., 2009;Pinto-Martin et al., 2011;Samadi, Mahmoodizadeh, & McConkey, 2012), and 21 studies were conducted in children below age 4 (Baird et al., 2000;Barbaro & Dissanayake, 2010;Chiang et al., 2013;Chlebowski, Robins, Barton, & Fein, 2013;Choueiri & Wagner, 2015;Corsello et al., 2007;Dereu et al., 2010;Dietz, Swinkels, van Daalen, van Engeland, & Buitelaar, 2006;Hedley et al., 2015;Kleinman et al., 2008;Nah, Young, Brewer, & Berlingeri, 2014;Nygren et al., 2012;Oosterling et al., 2009;Robins, 2008;Samadi & McConkey, 2015;Stone, Coonrod, Turner, & Pozdol, 2004;Stone, McMahon, & Henderson, 2008;Turner-Brown, Baranek, Reznick, Watson, & Crais, 2013;Wetherby, Brosnan-Maddox, Peace, & Newton, 2008). Additionally, we excluded 1 study that examined the Autism Diagnostic Inventory -Telephone Screening in Spanish (ADI-TSS) because in this study the ADI-TSS was validated against the ADI-R despite that the general structure and the majority of questions in the ADI-TSS were based on the ADI-R (Vrancic et al., 2002). ...
Background:
Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures.
Aims:
To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings.
Methods and procedures:
Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment.
Outcomes and results:
14 studies met the inclusion criteria, of which 11 studies were with children (4-18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included.
Conclusions and implications:
Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.
... Screening tools for toddlers during the second year of life include the CHAT [41,42] or a modified version of the CHAT, including the M-CHAT (Modified-CHAT)) [43,44] and the Q-CHAT (Quantitative-CHAT) [45]; the Checklist for Early Signs of Developmental Disorders (CESDD) [46]; the Brief Infant-Toddler Social and Emotional Assessment Questionnaire (BITSEA) [47]; the Young autism and other developmental disorders Checkup Tool at 18 months (Yacht 18) [48], the Social Attention and Communication Study (SACS) [49]; the Early Screening of Autistic Traits Questionnaire (ESAT) [50], and the Social Communication Questionnaire (SCQ) [51]. The CHAT was found to have a good specificity, but low sensitivity [52]; the M-CHAT showed better sensitivity, but produced many false positive scores. ...
Background
The need for early treatment of autism spectrum disorders (ASD) necessitates early screening. Very few tools have been prospectively tested with infants of less than 12 months of age. The PREAUT grid is based on dyadic assessment through interaction and shared emotion and showed good metrics for predicting ASD in very-high-risk infants with West syndrome.
Methods
We assessed the ability of the PREAUT grid to predict ASD in low-risk individuals by prospectively following and screening 12,179 infants with the PREAUT grid at four (PREAUT-4) and nine (PREAUT-9) months of age. A sample of 4,835 toddlers completed the Checklist for Autism in Toddlers (CHAT) at 24 months (CHAT-24) of age. Children who were positive at one screening (N = 100) were proposed a clinical assessment (including the Children Autism Rating Scale, a Developmental Quotient, and an ICD-10-based clinical diagnosis if appropriate) in the third year of life. A randomly selected sample of 1,100 individuals who were negative at all screenings was followed by the PMI team from three to five years of age to identify prospective false negative cases. The clinical outcome was available for 45% (N = 45) of positive children and 52.6% (N = 579) of negative children.
Results
Of the 100 children who screened positive, 45 received a diagnosis at follow-up. Among those receiving a diagnosis, 22 were healthy, 10 were diagnosed with ASD, seven with intellectual disability (ID), and six had another developmental disorder. Thus, 50% of infants positive at one screening subsequently received a neurodevelopmental diagnosis. The PREAUT grid scores were significantly associated with medium and high ASD risk status on the CHAT at 24 months (odds ratio of 12.1 (95%CI: 3.0–36.8), p < 0.001, at four months and 38.1 (95%CI: 3.65–220.3), p < 0.001, at nine months). Sensitivity (Se), specificity, negative predictive values, and positive predictive values (PPVs) for PREAUT at four or nine months, and CHAT at 24 months, were similar [PREAUT-4: Se = 16.0 to 20.6%, PPV = 25.4 to 26.3%; PREAUT-9: Se = 30.5 to 41.2%, PPV = 20.2 to 36.4%; and CHAT-24: Se = 33.9 to 41.5%, PPV = 27.3 to 25.9%]. The repeated use of the screening instruments increased the Se but not PPV estimates [PREAUT and CHAT combined: Se = 67.9 to 77.7%, PPV = 19.0 to 28.0%].
Conclusions
The PREAUT grid can contribute to very early detection of ASD and its combination with the CHAT may improve the early diagnosis of ASD and other neurodevelopmental disorders.
