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Title of Journal: J Autism Dev Disord

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Abbravation: Journal of Autism and Developmental Disorders

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Springer US

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DOI

10.1007/978-3-540-27863-4_15

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ISSN

1573-3432

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Comparative Analysis of Three Screening Instrument

Authors: Iris J Oosterling Sophie H Swinkels Rutger Jan van der Gaag Janne C Visser Claudine Dietz Jan K Buitelaar
Publish Date: 2009/02/10
Volume: 39, Issue: 6, Pages: 897-909
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Abstract

Several instruments have been developed to screen for autism spectrum disorders ASD in highrisk 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 ScalesDevelopmental Profile InfantToddler Checklist and key items of the Checklist for Autism in Toddlers in 238 children mean age = 296 months SD = 64 at risk for ASD Discriminative properties are compared in the whole sample and in two age groups separately 8–24 months and 25–44 months No instrument or individual item shows satisfying power in discriminating ASD from nonASD but pros and cons of instruments and items are discussed and directions for future research are proposedIn the last 15 years great efforts have been put into developing methods and instruments for earlier detection of autism spectrum disorder ASD Research projects show that earlier identification of children with ASD is indeed feasible Charman and Baird 2002 Two models for early detection of ASD prevail in the field The first model includes a systematic population screening firstlevel screening in which autismspecific screeners are applied to all children at certain ages eg 18 and 24 months of age eg by primary care providers in conjunction with routine developmental surveillance This population screening is advocated by the American Academy of Pediatrics Johnson et al 2007 The second model includes a twostage screening approach in which a specific screening instrument for ASD is only applied to children showing a deviant developmental path at a routine developmental surveillance secondlevel screening Such an approach is recommended in the Practice Parameters endorsed by the American Academy of Neurology and Child Neurology Society Filipek et al 2000Two screening instruments have been evaluated in large unselected population samples These firstlevel screening instruments are the Checklist for Autism in Toddlers CHAT BaronCohen et al 1992 BaronCohen et al 2000 and the Early Screening of Autistic Traits Questionnaire ESAT Dietz et al 2006 Swinkels et al 2006 The CHAT was developed in order to prospectively identify autism at 18 months of age in a general population sample BaronCohen et al 1992 This checklist is based on the assumption that early impairments of joint attention skills are precursors of problems in developing a theoryofmind functioning that is hypothesized to be a core deficit in autism later in life Charman and BaronCohen 2006 The CHAT assesses ‘simple’ pretend play and joint attention behaviours using parental report and health practitioner observation through direct testing The ESAT was developed to prospectively identify autism as early as at 14 months of age in a general population Dietz et al 2006 Swinkels et al 2006 Using an empirical bottomup approach potential screening items were selected from the literature and tested in a pilot study This resulted in the development of a populationbased prescreening instrument the 4item ESAT and a longer 14item version of the ESAT for use in populations at highrisk because either screened positive on the 4item ESAT or determined by other means to be at high riskSeveral other autismspecific screening instruments have been developed and further studied in recent years Examples of these screening instruments are the ModifiedCHAT MCHAT Robins et al 2001 the Social Communication Questionnaire SCQ Berument et al 1999 Rutter et al 2003 the Screening Test for Autism in Toddlers STAT Stone et al 2004 and the Pervasive Developmental Disorders Screening TestII PDDSTII Siegel 2004 A common characteristic of most of these screening instruments is the inclusion of items on all three areas of impairment in ASD The instruments vary however a in terms of coverage of other symptom areas b in terms of the age at which they are to be administered c as to whether they are to be used as a parent questionnaire or for direct observation by a professional Bryson et al 2003 and d as to whether they were originally intended and/or further studied as screens to be used in a general population firstlevel screening or in highrisk groups secondlevel screening For an overview of first and secondlevel screening instruments see Johnson et al 2007 p 1200–1201So far little research has been completed on comparing the properties of different screening instruments at an early age within the one and the same sample In addition empirical evidence with regard to the use of different items for children at different ages is limited Studies with the CHAT showed that items on pretend play and joint attention are important in screening children aged 18 months BaronCohen et al 1992 2000 whereas findings of the ESAT studies revealed that at 14 months of age items related to a direct smiling smile directed to others b reacting when spoken to and c interest in other people are most predictive for ASD Dietz et al 2006 Swinkels et al 2006The aim of the current study is to compare the properties of several different screening instruments for ASD and the discriminative value of their individual items used in the same sample of highrisk preschool children 8–44 months Special attention will be given to the influence of age on the usefulness of the different instruments as a whole and at item level For this comparison we opted for two autismspecific screening instruments namely the ESAT and the SCQ The SCQ is a screening instrument for autism to be completed by parents or caregivers which was designed for individuals aged 4 years and older It is based on the Autism Diagnostic InterviewRevised Lord et al 1994 Until now little is known about the applicability of the SCQ in a younger population Berument et al 1999 We added a more general instrument for screening of communication and symbolic behaviour in young children the Communication and Symbolic Behavior ScalesDevelopmental Profile InfantToddler Checklist CSBSDP Wetherby and Prizant 2002 Furthermore particular attention was given to the use of the CHATkeyconcepts joint attention and pretend play


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Other Papers In This Journal:

  1. Hospitalizations of Children with Autism Increased from 1999 to 2009
  2. Evaluating Posed and Evoked Facial Expressions of Emotion from Adults with Autism Spectrum Disorder
  3. Profound Expressive Language Impairment in Low Functioning Children with Autism: An Investigation of Syntactic Awareness Using a Computerised Learning Task
  4. Brief Report: “Quick and (not so) Dirty” Assessment of Change in Autism: Cross-Cultural Reliability of the Developmental Disabilities CGAS and the OSU Autism CGI
  5. The Social Orienting Continuum and Response Scale (SOC-RS): A Dimensional Measure for Preschool-aged Children
  6. Familial Autoimmune Thyroid Disease as a Risk Factor for Regression in Children with Autism Spectrum Disorder: A CPEA Study
  7. Adaptive Functioning in Autism Spectrum Disorder During the Transition to Adulthood
  8. Scott Bellini, Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties (Textbook Edition, 1st ed.)
  9. An Effective Neurofeedback Intervention to Improve Social Interactions in Children with Autism Spectrum Disorder
  10. Evidence-Based Behavioral Interventions for Repetitive Behaviors in Autism
  11. O. Ivar Lovaas: Pioneer of Applied Behavior Analysis and Intervention for Children with Autism
  12. Global–Local Visual Processing in High Functioning Children with Autism: Structural vs. Implicit Task Biases
  13. Association of Rigid-Compulsive Behavior with Functional Constipation in Autism Spectrum Disorder
  14. Anxiety and Sensory Over-Responsivity in Toddlers with Autism Spectrum Disorders: Bidirectional Effects Across Time
  15. Offit Paul: Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure
  16. Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder
  17. Brief Report: Are Autistic-Behaviors in Children Related to Prenatal Vitamin Use and Maternal Whole Blood Folate Concentrations?
  18. Do Researchers Evaluate Psychosocial Interventions for Autism from the Perspective of the Three Dominant Cognitive Autism Theories?
  19. Daytime Secretion of Salivary Cortisol and Alpha-Amylase in Preschool-Aged Children with Autism and Typically Developing Children
  20. Factor Analysis of the Childhood Autism Rating Scale in a Sample of Two Year Olds with an Autism Spectrum Disorder
  21. Knowledge and Use of Intervention Practices by Community-Based Early Intervention Service Providers
  22. Breif Report: Sensory Abnormalities as Distinguishing Symptoms of Autism Spectrum Disorders in Young Children
  23. C. Avraham-Krehwinkel and D. Aldridge, A Non-Violent Resistance Approach with Children in Distress: A Guidebook for Parents and Professionals
  24. Evidence-Based Social Skills Training for Adolescents with Autism Spectrum Disorders: The UCLA PEERS Program
  25. The Collateral Effects of Joint Attention Training on Social Initiations, Positive Affect, Imitation, and Spontaneous Speech for Young Children with Autism
  26. The Effectiveness of Parent–Child Interaction Therapy for Families of Children on the Autism Spectrum
  27. JADD Announcements for September 2009
  28. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study
  29. Effects of Cognitive Behavioral Therapy on Daily Living Skills in Children with High-Functioning Autism and Concurrent Anxiety Disorders
  30. Prenatal and Neonatal Thyroid Stimulating Hormone Levels and Autism Spectrum Disorders
  31. Metabolic Imbalance Associated with Methylation Dysregulation and Oxidative Damage in Children with Autism
  32. Employment and Vocational Skills Among Individuals with Autism Spectrum Disorder: Predictors, Impact, and Interventions
  33. Intact Spectral but Abnormal Temporal Processing of Auditory Stimuli in Autism
  34. Brief Report: The ADOS Calibrated Severity Score Best Measures Autism Diagnostic Symptom Severity in Pre-School Children
  35. Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study
  36. Differentiating between Autism Spectrum Disorders and Other Developmental Disabilities in Children Who Failed a Screening Instrument for ASD
  37. Discriminant and Convergent Validity of the Anxiety Construct in Children with Autism Spectrum Disorders
  38. Using Discrete Trial Training to Identify Specific Learning Impairments in Boys with Fragile X Syndrome
  39. Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II
  40. A Review of the Use of Touch-Screen Mobile Devices by People with Developmental Disabilities
  41. Social and Non-social Hazard Response in Drivers with Autism Spectrum Disorder
  42. Using Carey Temperament Scales to Assess Behavioral Style in Children with Autism Spectrum Disorders
  43. Brief Report: Learning Via the Electronic Interactive Whiteboard for Two Students with Autism and a Student with Moderate Intellectual Disability
  44. Maternal Smoking and Autism Spectrum Disorder: A Meta-analysis
  45. Brief Report: Adaptive Behavior and Cognitive Skills for Toddlers on the Autism Spectrum
  46. Response Times of Children and Adolescents with Asperger Syndrome on an ‘Advanced’ Test of Theory of Mind
  47. Group Intervention to Promote Social Skills in School-age Children with Pervasive Developmental Disorders: Reconsidering Efficacy
  48. Prevalence and Correlates of Screen-Based Media Use Among Youths with Autism Spectrum Disorders
  49. Brief Report: Pragmatic Language in Autism Spectrum Disorder: Relationships to Measures of Ability and Disability
  50. An Electrophysiological Investigation of Interhemispheric Transfer Time in Children and Adolescents with High-Functioning Autism Spectrum Disorders
  51. Diary Reports of Concerns in Mothers of Infant Siblings of Children with Autism Across the First Year of Life
  52. The Social Behavioral Phenotype in Boys and Girls with an Extra X Chromosome (Klinefelter Syndrome and Trisomy X): A Comparison with Autism Spectrum Disorder
  53. Brief Report: Influence of Physical Activity on Sleep Quality in Children with Autism
  54. Reliability and Validity of Parent- and Child-Rated Anxiety Measures in Autism Spectrum Disorder
  55. Early Language Patterns of Toddlers on the Autism Spectrum Compared to Toddlers with Developmental Delay
  56. Explaining and Selecting Treatments for Autism: Parental Explanatory Models in Taiwan
  57. Open-Label Memantine in Fragile X Syndrome
  58. Brief Report: The Effects of Tomatis Sound Therapy on Language in Children with Autism
  59. Meg Grigal and Debra Hart: Think College
  60. Daily Couple Experiences and Parent Affect in Families of Children with Versus Without Autism
  61. In the Eye of the Beholder: Rapid Visual Perception of Real-Life Scenes by Young Adults with and Without ASD
  62. Brief Report: Effects of Sensory Sensitivity and Intolerance of Uncertainty on Anxiety in Mothers of Children with Autism Spectrum Disorder
  63. Network Approach to Autistic Traits: Group and Subgroup Analyses of ADOS Item Scores
  64. Residual Difficulties with Categorical Induction in Children with a History of Autism
  65. No Evidence of Emotional Dysregulation or Aversion to Mutual Gaze in Preschoolers with Autism Spectrum Disorder: An Eye-Tracking Pupillometry Study
  66. Gender in Voice Perception in Autism
  67. The Relationship Between Clinical Presentation and Unusual Sensory Interests in Autism Spectrum Disorders: A Preliminary Investigation
  68. Views on the Diagnostic Labels of Autism and Asperger’s Disorder and the Proposed Changes in the DSM
  69. Adaptive Profiles in Autism and Other Neurodevelopmental Disorders
  70. Mothers of Children with Developmental Disorders in the Bedouin Community in Israel: Family Functioning, Caregiver Burden, and Coping Abilities
  71. Scalar Inferences in Autism Spectrum Disorders
  72. Use of a Teacher Nomination Strategy to Screen for Autism Spectrum Disorders in General Education Classrooms: A Pilot Study

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