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Screening for autism in preterm children : diagnostic\ud utility of the Social Communication Questionnaire

By Samantha J. Johnson, Chris Hollis, Enid M. Hennessy, Puja Kochhar, Dieter Wolke and Neil Marlow

Abstract

Objective Preterm survivors are at high risk for autism\ud spectrum disorders (ASD). The diagnostic utility of the\ud Social Communication Questionnaire (SCQ) in screening\ud for ASD was assessed in extremely preterm children at\ud 11 years of age.\ud Design All babies born at <26 weeks gestation\ud in UK and Ireland from March through December\ud 1995 were recruited to the EPICure Study. Of 307\ud survivors, 219 (71%) were assessed at 11 years.\ud Parents of 173 children completed the SCQ to screen\ud for autistic features and the Development and Well\ud Being Assessment (DAWBA) psychiatric interview.\ud A consensus diagnosis of ASD was assigned by two\ud child psychiatrists following review of the DAWBA\ud parental interview and corresponding DAWBA teacher\ud questionnaire.\ud Setting Community-based follow-up.\ud Results Using the established SCQ cut-off (scores\ud ≥15), 28 (16%) extremely preterm children screened\ud positive for ASD. Eleven (6%) were assigned a\ud diagnosis of ASD. Using this cut-off, the SCQ had 82%\ud sensitivity and 88% specifi city for identifying ASD in this\ud population. Using a receiver operating characteristic\ud curve, SCQ scores ≥14 had optimal diagnostic utility\ud (area under curve: 0.94; sensitivity: 91%; specifi city:\ud 86%). Positive predictive value was relatively low\ud (31%) resulting in numerous over-referrals. However,\ud children with false positive screens had signifi cantly\ud worse neuro-developmental, cognitive and behavioural\ud outcomes than those with true negative screens.\ud Conclusion The SCQ has good diagnostic utility for\ud identifying ASD in extremely preterm children and\ud is a useful screening tool in this population. Children\ud with false positive screens represent a high-risk group\ud in whom further diagnostic assessment would be\ud benefi cial

Topics: RC, RJ
Publisher: BMJ Group
Year: 2011
OAI identifier: oai:wrap.warwick.ac.uk:3697

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