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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Early and Repeated Screening Detects Autism Spectrum Disorder
The Journal of pediatrics, v 234, pp 227-235
Jul 2021
PMID: 33711288
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate timing and accuracy of early and repeated screening for autism spectrum disorder (ASD) during well-child visits.
Using a longitudinal study design, toddlers (n = 5784) were initially screened at 12 (n = 1504), 15 (n = 1228), or 18 (n = 3052) months during well-child visits, and rescreened at 18, 24, and 36 months. Of those screened, 368 toddlers attended an ASD evaluation after a positive screen and/or a provider concern for ASD at any visit.
Screens initiated at 12 months yielded an ASD diagnosis significantly earlier than at 15 months (P = .003, d = 0.99) and 18 months (P < .001, d = 0.97). Cross-group overall sensitivity of the initial screen was .715 and specificity was .959. Repeat screening improves sensitivity (82.1%), without notably decreasing specificity (all >93.5%). Screening at 18 months resulted in significantly higher positive predictive value than at 12 months (X2 (1, n = 221) = 9.87, P = .002, OR = 2.60) and 15 months (X2 (1, n = 208) = 14.57, P < .001, OR = 3.67). With repeat screening, positive predictive value increased for all screen groups, but the increase was not significant.
Screening as early as 12 months effectively identifies many children at risk for ASD. Children screened at 12 months receive a diagnosis of ASD significantly earlier than peers who are first screened at later ages, facilitating earlier intervention. However, as the sensitivity is lower for a single screen, screening needs to be repeated.
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Details
- Title
- Early and Repeated Screening Detects Autism Spectrum Disorder
- Creators
- Andrea Trubanova Wieckowski - Drexel UniversityTaralee Hamner - Drexel UniversitySarah Nanovic - Drexel UniversityKatelynn S. Porto - University of ConnecticutKirsty L. Coulter - University of ConnecticutSherief Y. Eldeeb - Drexel UniversityChi-Ming A. Chen - University of ConnecticutDeborah A. Fein - University of ConnecticutMarianne L. Barton - University of ConnecticutLauren B. Adamson - Georgia State UniversityDiana L. Robins - Drexel University
- Publication Details
- The Journal of pediatrics, v 234, pp 227-235
- Publisher
- Elsevier
- Grant note
- R01HD039961 / Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000664383600043
- Scopus ID
- 2-s2.0-85103217285
- Other Identifier
- 991019167907704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics