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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


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:

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  1. a s s a n H , S u l l i v a n N R , et al. Positive screening for autism in ex-preterm infants: prevalence and risk factors. doi
  2. a v i d A B , R u s y n i a k J , et al. Performance of the Social Communication Questionnaire in children receiving preschool special education services. doi
  3. (1983). Assessment Battery for Children. Circle Pines, MN: American Guidance Service, Inc, doi
  4. Autism screening tools: an evaluation of the Social Communication Questionnaire and the Developmental Behaviour Checklist-Autism Screening Algorithm. doi
  5. (2003). B a i l e y A , L o r d C . T h e S o c i a l C o m m u n i c a t i o n Q u e s t i o n n a i r e . L o s Angeles, CA: Western Psychological Services,
  6. B a i r d G , S i m o n o f f E , et al. Effi cacy of three screening instruments in the identifi cation of autistic-spectrum disorders.
  7. C h a r m a n T, B a i r d G , et al. Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. doi
  8. F a w k e doi
  9. (2000). F o r d T, R i c h a r d s H , et al. The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. doi
  10. Fombonne E, S i m m o n s H , F o r d T, et al. Prevalence of pervasive developmental disorders in the British nationwide survey of child mental health. doi
  11. H e n n e s s y E , S m i t h doi
  12. H o l l i s C , K o c h h a r P, et al. Autism spectrum disorders in extremely preterm children. doi
  13. H o l l i s C , K o c h h a r P, et al. Psychiatric disorders in extremely preterm children: longitudinal fi nding at age 11 years in the EPICure study. doi
  14. H u s V, P i c k l e s A , et al. Between a ROC and a hard place: decision making and making decisions about using the SCQ. doi
  15. Heiervang E, S t o r m a r k K M , L u n d e r v o l d A doi
  16. (2005). M c G i n n i t y A , M e l t z e r doi
  17. Motor and executive function at doi
  18. Pervasive behavior problems at 6 years of age in a total-population sample of children born at </= 25 weeks of gestation. doi
  19. Positive screening results on the modifi ed checklist for autism in toddlers: implications for very preterm populations. doi
  20. (2000). Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. Text Revision. doi
  21. r a d e l l a A , G o r r i n d o T, et al. Autism spectrum traits in children with mood and anxiety disorders.
  22. R a t s c h i n s k i G , O h r t B , et al. The cognitive outcome of very preterm infants may be poorer than often reported: an empirical investigation of how methodological issues make a big difference. doi
  23. R i c h a r d s o n T, A n n e y doi
  24. (1999). R u t t e r M , L o r d C , et al. Autism screening questionnaire: diagnostic validity. doi
  25. S h e a T M , A l l r e d doi
  26. S i l o v e N , W i l l i a m s K , et al. Validity of the social communication questionnaire in assessing risk of autism in preschool children with developmental problems. doi
  27. S o m m e r f e l t K , M a r k e s t a d T. P o p u l a t i o n b a s e d , c o n t r o l l e d s t u d y o f behavioural problems and psychiatric disorders in low birthweight children at doi
  28. Screening for autism: agreement with diagnosis. doi
  29. Screening for developmental and behavioral problems. doi
  30. Ta y l o r H G , S c h l u c h t e r M , et al. Behavioral outcomes of extremely low birth weight children at age 8 years. doi
  31. The British Child and Adolescent Mental Health Survey 1999: The prevalence of DSM-IV disorders. doi
  32. (2010). The prevalence of autism spectrum disorders: impact of diagnostic instrument and non-response bias. doi
  33. The Strengths and Diffi culties Questionnaire: a research note.
  34. V i k T, H e y e r d a h l S , et al. Psychiatric symptoms and disorders in adolescents with low birth weight. Arch Dis Child Fetal Neonatal Ed doi
  35. W o l k e D , M a r l o w N . D e v e l o p m e n t a l a s s e s s m e n t o f p r e t e r m i n f a n t s at 2 years: validity of parent reports. doi
  36. years of age after extremely preterm birth. doi
  37. years of age in children born before 26 weeks of gestation. Pediatrics doi
  38. (2002). years of age. Arch Dis Child Fetal Neonatal Ed

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