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Lee CM, Altschuler MR, Esler AN, Burrows CA, Hudock RL. Why are only some children with autism spectrum disorder misclassified by the social communication questionnaire? An empirical investigation of individual differences in sensitivity and specificity in a clinic-referred sample. J Neurodev Disord 2023; 15:28. [PMID: 37608249 PMCID: PMC10463287 DOI: 10.1186/s11689-023-09497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/26/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The Social Communication Questionnaire (SCQ) is a checklist for autism spectrum disorder (ASD) commonly used in research and clinical practice. While the original validation study suggested that the SCQ was an accurate ASD screener with satisfactory sensitivity and specificity, subsequent studies have yielded mixed results, with some revealing low sensitivity, low specificity, and low utility in some settings. METHOD The present study examined the psychometric properties of the SCQ as well as the individual difference characteristics of 187 individuals with and without autism spectrum disorder (ASD) who were misclassified or accurately classified by the SCQ in a clinic-referred sample. RESULTS The SCQ showed suboptimal sensitivity and specificity, regardless of age and sex. Compared to true positives, individuals classified as false positives displayed greater externalizing and internalizing problems, whereas individuals classified as false negatives displayed better social communication and adaptive skills. CONCLUSIONS The findings suggest that non-autistic developmental and behavioral individual difference characteristics may explain high rates of misclassification using the SCQ. Clinicians and researchers could consider using the SCQ in combination with other tools for young children with internalizing and externalizing symptoms and other more complex clinical presentations.
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Affiliation(s)
- Chimei M Lee
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA.
| | | | - Amy N Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
| | - Catherine A Burrows
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
| | - Rebekah L Hudock
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
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Mack JT, Wolff N, Kohls G, Becker A, Stroth S, Poustka L, Kamp-Becker I, Roessner V. Social and Nonsocial Autism Symptom Domains in Children and Adolescents with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder: Insights into Their Symptomatological Interplay. Psychopathology 2023; 56:8-16. [PMID: 34923498 DOI: 10.1159/000520957] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/10/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) share overlapping symptomatology, particularly with regard to social impairments (including peer relationship difficulties), and they frequently co-occur. However, the nature of their co-occurrence remains unclear. Therefore, the current study aimed to examine the nature of the transdiagnostic link between ASD and ADHD from a symptomatological point of view measured with the Autism Diagnostic Observation Schedule (ADOS Module 3) and the Autism Diagnostic Interview-Revised (ADI-R). METHODS We analyzed the social and nonsocial ASD symptom domain scores from both diagnostic instruments in 4 clinically referred groups (i.e., ASD, ADHD, ASD + ADHD, and no psychiatric diagnosis) without other co-occurring mental disorders using a two-by-two full-factorial MANOVA design with the factors ASD (yes/no) and ADHD (yes/no). RESULTS We found no ASD by ADHD interaction effects across all symptom domain scores of ADOS and ADI-R, except for ADOS imagination/creativity. There were only main effects of the factor ASD but no main effects of ADHD. Follow-up contrasts showed that exclusively, ASD had an impact on the measured symptomatology in case of co-occurring ASD + ADHD. CONCLUSION Overall, the results support an additive model of the symptomatology across areas of communication, social interaction, and stereotyped behaviors and restricted interests in case of the co-occurrence of ASD and ADHD when assessed with ADOS/ADI-R. Thus, one can assume that the phenotypic overlap of ASD + ADHD may be less complicated than suspected - at least with regard to ASD symptomatology - and that in the presence of ADHD, ASD symptomatology is generally well measurable with best-practice diagnostic instruments.
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Affiliation(s)
- Judith T Mack
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Gregor Kohls
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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Guttentag S, Bishop S, Doggett R, Shalev R, Kaplan M, Dyson M, Cohen M, Lord C, Di Martino A. The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:473-487. [PMID: 34219504 DOI: 10.1177/13623613211030071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.
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Affiliation(s)
- Sara Guttentag
- Child Mind Institute, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, USA.,Hassenfeld Children's Hospital at NYU Langone, USA
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Horwitz EH, Schoevers RA, Greaves-Lord K, de Bildt A, Hartman CA. Adult Manifestation of Milder Forms of Autism Spectrum Disorder; Autistic and Non-autistic Psychopathology. J Autism Dev Disord 2020; 50:2973-2986. [PMID: 32052317 PMCID: PMC7374470 DOI: 10.1007/s10803-020-04403-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger’s Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher on a dimensional ASD self- and other-report measure than clinical controls, the majority did not exceed the ASD cutoff according to the Autism Diagnostic Observation Schedule. Part of the individuals with an ASD diagnosis in their youth no longer show behaviors that underscribe a clinical ASD diagnosis in adulthood, but have subtle difficulties in social functioning and a vulnerability for a range of other psychiatric disorders.
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Affiliation(s)
- E H Horwitz
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. .,GGZ Friesland, Leeuwarden, The Netherlands.
| | - R A Schoevers
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | | | - A de Bildt
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - C A Hartman
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Hyman SL, Levy SE, Myers SM. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics 2020; 145:peds.2019-3447. [PMID: 31843864 DOI: 10.1542/peds.2019-3447] [Citation(s) in RCA: 484] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with reported prevalence in the United States of 1 in 59 children (approximately 1.7%). Core deficits are identified in 2 domains: social communication/interaction and restrictive, repetitive patterns of behavior. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Standardized screening for ASD at 18 and 24 months of age with ongoing developmental surveillance continues to be recommended in primary care (although it may be performed in other settings), because ASD is common, can be diagnosed as young as 18 months of age, and has evidenced-based interventions that may improve function. More accurate and culturally sensitive screening approaches are needed. Primary care providers should be familiar with the diagnostic criteria for ASD, appropriate etiologic evaluation, and co-occurring medical and behavioral conditions (such as disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder, anxiety, and wandering) that affect the child's function and quality of life. There is an increasing evidence base to support behavioral and other interventions to address specific skills and symptoms. Shared decision making calls for collaboration with families in evaluation and choice of interventions. This single clinical report updates the 2007 American Academy of Pediatrics clinical reports on the evaluation and treatment of ASD in one publication with an online table of contents and section view available through the American Academy of Pediatrics Gateway to help the reader identify topic areas within the report.
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Affiliation(s)
- Susan L Hyman
- Golisano Children's Hospital, University of Rochester, Rochester, New York;
| | - Susan E Levy
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Scott M Myers
- Geisinger Autism & Developmental Medicine Institute, Danville, Pennsylvania
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Mouti A, Dryer R, Kohn M. Differentiating Autism Spectrum Disorder From ADHD Using the Social Communication Questionnaire. J Atten Disord 2019; 23:828-837. [PMID: 29936891 DOI: 10.1177/1087054718781945] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study examined the ability of the Social Communication Questionnaire (SCQ) to differentiate between autism spectrum disorder (ASD), ADHD, and typically developing (TD) children. METHOD Children ( Mage = 11.27 years, SDage = 3.28) identified with ASD Severity Levels "1" and/or "2" ( n = 28), ADHD ( n = 44), dual diagnoses of ADHD and ASD ( n = 29), and TD ( n = 61) were assessed using the SCQ. RESULTS The SCQ differentiated between ASD and non-ASD groups. Children with ASD had higher total and domain scores on the SCQ than ADHD and TD children. The optimal cutoff total score of 13 was identified for differentiating between ASD and ADHD groups (area under the curve [AUC] = .96). Twenty eight of the 39 items were identified as significant in differentiating between ASD and ADHD. CONCLUSION The SCQ continues to be a well-validated screening tool for ASD and is suitable for determining whether further ASD assessment is warranted in children with ADHD symptoms.
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Affiliation(s)
- Anissa Mouti
- 1 Charles Sturt University, Bathurst, New South Wales, Australia
| | - Rachel Dryer
- 2 Australian College of Applied Psychology, Sydney, New South Wales, Australia
| | - Michael Kohn
- 3 The Children's Hospital at Westmead, New South Wales, Australia
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Medda JE, Cholemkery H, Freitag CM. Sensitivity and Specificity of the ADOS-2 Algorithm in a Large German Sample. J Autism Dev Disord 2019; 49:750-761. [PMID: 30238180 PMCID: PMC6373322 DOI: 10.1007/s10803-018-3750-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The aim of the present study was to establish diagnostic validity of the new algorithm of the Autism Diagnostic Observation Scale, the ADOS-2, to differentiate between ASD and other clinically relevant psychiatric and developmental disorders in a large German sample. Validity of ADOS and ADOS-2 diagnostic algorithms was established in 826 individuals (n = 455 autism, n = 216 autism spectrum, n = 155 non-ASD patients) by receiver operating curves. Confidence intervals overlapped largely for ADOS and ADOS-2 algorithms, confirming diagnostic validity of both algorithms. Adding information of the Social Communication Questionnaire and the Social Responsiveness Scale resulted in slightly improved classification rates for autism in Module 4. We thus replicated previous findings of the diagnostic validity of the ADOS-2 algorithms.
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Affiliation(s)
- Juliane E Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
| | - Hannah Cholemkery
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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Kamp-Becker I, Langmann A, Stehr T, Custodis K, Poustka L, Becker K. Zur Validität der deutschen Fassung der ADOS-2 unter Berücksichtigung von Geschlechtseffekten. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:193-207. [DOI: 10.1024/1422-4917/a000492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Fragestellung: Die deutschsprachige Version der Diagnostischen Beobachtungsskala für Autistische Störungen – 2 (ADOS-2) ist eine Revision der standardisierten Verhaltensbeobachtung für Personen mit dem Verdacht auf Vorliegen einer Autismus-Spektrum-Störung (ASS). Die Studie untersucht die diagnostische Güte der originalen und revidierten Algorithmen für die Module 1 bis 3. Methodik: An einer großen Inanspruchnahmepopulation (N = 1080, Alter 1.7–20.5 Jahre) wurde die Unterscheidungsfähigkeit der ADOS-2 zu relevanten Differenzialdiagnosen untersucht. Außerdem wurden Vergleiche bezüglich der diagnostischen Güte für beide Geschlechter getrennt vorgenommen. Ergebnisse: Der revidierte Algorithmus weist eine verbesserte Sensitivität (84.9 %) bei jedoch leicht reduzierter Spezifität (85.7 %) auf. Verbesserungen der ADOS-2 betreffen vor allem Fälle von frühkindlichem Autismus und die korrekte Klassifizierung von Mädchen. Der Einschluss von repetitiven, stereotypen Verhaltensweisen in den Algorithmus erhöht die korrekte Klassifikation in den Modulen 2 und 3. Für jüngere Kinder im Modul 1 ist dies jedoch nicht der Fall. Es zeigt sich darüber hinaus eine geringere Differenzierungsfähigkeit zu internalisierenden Störungen und Störungen des Sozialverhaltens. Schlussfolgerungen: Eine gute diagnostische Güte der ADOS-2 wurde vor allem für Kinder mit durchschnittlichen kognitiven Fähigkeiten gefunden. Die Ergebnisse sprechen für eine gute Anwendbarkeit der ADOS-2 für klinische Populationen. Voraussetzung ist jedoch eine sorgfältige und breite Diagnostik durch erfahrene Untersucher. Schlüsselwörter: ADOS, Diagnostik von Autismus-Spektrum-Störungen, Sensitivität, Spezifität
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Affiliation(s)
- Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Anika Langmann
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Thomas Stehr
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Katharina Custodis
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Luise Poustka
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim
- Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien
| | - Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
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van Steensel FJA, Heeman EJ. Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:1753-1767. [PMID: 28680259 PMCID: PMC5487760 DOI: 10.1007/s10826-017-0687-7] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.
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Affiliation(s)
- Francisca J. A. van Steensel
- Child Development and Education, University of Amsterdam, Research priority area Yield, Nieuwe Achtergracht 127, 1018 WS Amsterdam, Netherlands
| | - Emma J. Heeman
- De Opvoedpoli B.V., Dorpstraat 145, 2712 AG Zoetermeer, Netherlands
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Grzadzinski R, Dick C, Lord C, Bishop S. Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5. Mol Autism 2016; 7:7. [PMID: 26788284 PMCID: PMC4717584 DOI: 10.1186/s13229-016-0072-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/12/2016] [Indexed: 11/20/2022] Open
Abstract
Background Children with attention deficit/hyperactivity disorder (ADHD) often present with social difficulties, though the extent to which these clearly overlap with symptoms of autism spectrum disorder (ASD) is not well understood. Methods We explored parent-reported and directly-observed ASD symptoms on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) in children referred to ASD-specialty clinics who received diagnoses of either ADHD (n = 48) or ASD (n = 164). Results Of the ADHD sample, 21 % met ASD cut-offs on the ADOS and 30 % met ASD cut-offs on all domains of the ADI-R. Four social communication ADOS items (Quality of Social Overtures, Unusual Eye Contact, Facial Expressions Directed to Examiner, and Amount of Reciprocal Social Communication) adequately differentiated the groups while none of the items on the ADI-R met the criteria for adequate discrimination. Conclusions Results of this work highlight the challenges that clinicians and researchers face when distinguishing ASD from other disorders in verbally fluent, school-age children.
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Affiliation(s)
- Rebecca Grzadzinski
- Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA ; Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027 USA
| | - Catherine Dick
- Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA
| | - Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA
| | - Somer Bishop
- School of Medicine, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143 USA
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Kim JH, Sunwoo HJ, Park SB, Noh DH, Jung YK, Cho IH, Cho SC, Kim BN, Shin MS, Kim JW, Park TW, Son JW, Chung US, Yoo HJ. A Validation Study of the Korean Version of Social Communication Questionnaire. Soa Chongsonyon Chongsin Uihak 2015. [DOI: 10.5765/jkacap.2015.26.3.197] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hoffmann W, Heinzel-Gutenbrunner M, Becker K, Kamp-Becker I. [Screening interview for early detection of high-functioning autism spectrum disorders]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2015; 43:207-18; quiz 218-9. [PMID: 26098008 DOI: 10.1024/1422-4917/a000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Various different questionnaires are available for the screening of autism spectrum disorders (ASD). These screening instruments show high sensitivity and are able to identify a large number of individuals with ASD, but they lack the specificity to differentiate individuals with ASD from those children and adolescents with other complex neurobehavioural disorders (such as attention-deficit/hyperactivity disorder, emotional disorders, and others), especially for those without intellectual disabilities. METHOD The present study evaluates the data of 309 individuals (153 with high-functioning ASD, 156 with other psychiatric disorders, IQ > 70) to find out whether selected items of the ADI-R can be used for an economic and sensitive screening of high-functioning ASD. RESULTS The results show that 8 items of the ADI-R can be used to discriminate high-functioning ASD and other psychiatric disorders. A cutoff of 5 led to a sensitivity of 0.93 and a cutoff of 6 to a specificity of 0.74. CONCLUSION The combination of early onset, serious abnormalities in social contact with stereotyped or compulsive-ritualized behaviour or interests can be detected with few interview questions for screening of ASD. Nevertheless, a more detailed and specific assessment in an expert setting should follow the screening process.
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Affiliation(s)
- Wiebke Hoffmann
- 1 Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie der Phillips-Universität Marburg
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