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Early and Repeated Screening Detects Autism Spectrum Disorder.
Wieckowski, Andrea Trubanova; Hamner, Taralee; Nanovic, Sarah; Porto, Katelynn S; Coulter, Kirsty L; Eldeeb, Sherief Y; Chen, Chi-Ming A; Fein, Deborah A; Barton, Marianne L; Adamson, Lauren B; Robins, Diana L.
Afiliación
  • Wieckowski AT; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA. Electronic address: atw64@drexel.edu.
  • Hamner T; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
  • Nanovic S; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
  • Porto KS; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Coulter KL; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Eldeeb SY; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
  • Chen CA; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Fein DA; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Barton ML; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Adamson LB; Department of Psychology, Georgia State University, Atlanta, GA.
  • Robins DL; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
J Pediatr ; 234: 227-235, 2021 Jul.
Article en En | MEDLINE | ID: mdl-33711288
OBJECTIVE: To evaluate timing and accuracy of early and repeated screening for autism spectrum disorder (ASD) during well-child visits. STUDY DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tamizaje Masivo / Trastorno del Espectro Autista Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tamizaje Masivo / Trastorno del Espectro Autista Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos