The Autism Detection in Early Childhood Tool: Level 2 autism spectrum disorder screening in a NICU Follow-up program |
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| Affiliation: | 1. Department of Pediatrics, Division of Pediatric Neurology, Nationwide Children’s Hospital, Columbus, OH, USA;2. Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA;3. Department of Pediatrics, Division of Developmental Behavioral Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA;4. Department of Psychiatry and Behavioral Health, Nationwide Children’s Hospital, Columbus, OH, USA;5. Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA;6. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA;1. Montclair State University, United States;2. The Johns Hopkins University, United States;1. Department of Psychology, The College of Staten Island, The City University of New York, 2800 Victory Blvd., 4S-108, SI, NY, 10314, United States;2. The Graduate Center of the City University of New York, United States;3. Department of Mathematics, The College of Staten Island, The City University of New York, 2800 Victory Blvd., SI, NY, 10314, United States;1. Department of Psychology, Northwestern University, Evanston, IL, United States;2. Institute of Policy Research, Northwestern University, Evanston, IL, United States |
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| Abstract: | ObjectiveChildren born preterm are at increased risk for autism spectrum disorder (ASD). However, early diagnosis of ASD is challenging because conventional screening Level 1 tools are less reliable in this population. We sought to determine whether the Autism Detection in Early Childhood (ADEC) and Child Behavior Checklist (CBCL) could accurately identify children at risk for ASD in a NICU Follow-up setting and thus facilitate referral for formal ASD evaluation.MethodChildren aged 18–36 months were recruited from a NICU Follow-up program. All children received presumptive diagnoses based on DSM-5 criteria and were screened for ASD risk with the ADEC and CBCL. Children scoring in the “at risk” range on either tool were referred for a full diagnostic ASD evaluation.ResultsSixty-nine patients (median birth weight 1140 g; median gestational age 28 weeks) were included with 18 designated “at risk” for ASD. Nine (13 %) scored “at risk” on the ADEC and 12 (17 %) on the CBCL. Thirteen children underwent diagnostic ASD evaluation with 9 receiving a formal diagnosis of ASD. The ADEC demonstrated the best performance (sensitivity 89 %, specificity 98 %). The CBCL was less sensitive (sensitivity 50 %, specificity 90 %). Requiring elevated scores on both the CBCL and ADEC was specific but not sensitive (sensitivity 33 %, specificity 100 %).ConclusionThe ADEC performed well in identifying children at risk for ASD within this high-risk NICU cohort, adding benefit as an autism-specific screening tool over the CBCL alone. |
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| Keywords: | Preterm NICU Follow Up Autism spectrum disorder Screening |
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