Receiver operating characteristic curve analysis of the Child Behavior Checklist and Teacher’s Report Form for assessing autism spectrum disorder in preschool-aged children

Tiago S Bara,1,2 Antonio C Farias,1–4 Erico PG Felden,5 Mara L Cordeiro1,2,6 1Neurosciences Core, Pelé Pequeno Príncipe Research Institute, 2Faculdades Pequeno Príncipe, 3Department of Neuropediatrics, Children’s Hospital, Pequeno Príncipe, 4School of Medicine, University Positivo, Curitiba, 5Centro de Ciências da Saúde e do Esporte (CEFID) da Universidade do Estado de Santa Catarina, Florianópolis, Brazil; 6Department of Psychiatry and Biobehavior Sciences, David Geffen School of Medicine, Semel Institute for Neusroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social, behavioral, and communication impairments with an estimated prevalence of 1 in 68 school-aged children. There is a need for objective and easily applicable instruments for early identification of autistic children to enable initiation of early interventions during a very sensitive period of brain development and, consequently, optimize prognosis. Here, we tested the utility of the Child Behavior Checklist (CBCL) and the Caregiver-Teacher’s Report Form (C-TRF) scales for assessing ASD in Brazil, where ASD screening research is emergent.Subjects and methods: A total of 70 children (2–5 years old, both sexes) were enrolled, including an ASD group (n=39) and a non-ASD control group (n=31). The preschool versions of the CBCL and C-TRF were applied. The CBCL and C-TRF results were compared between the ASD and non-ASD control groups with Mann–Whitney U tests and receiver operating characteristic analyses.Results: The CBCL and C-TRF were found to have moderate accuracy for the dimensions withdrawn and autism spectrum problems, and to correlate with each other.Conclusion: The CBCL and C-TRF may aid in early ASD detection. Keywords: screening, instruments, AUC, early interventio

Attention–memory training yields behavioral and academic improvements in children diagnosed with attention-deficit hyperactivity disorder comorbid with a learning disorder

Antonio Carlos Farias,1–4 Mara L Cordeiro,1,2,5 Erico PG Felden,6 Tiago S Bara,1,2 Cássia R Benko,1,2 Daniele Coutinho,1,2 Leandra F Martins,2 Rosilda TC Ferreira,1,2 James T McCracken5 1Faculdades Pequeno Príncipe, 2Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba, 3Department of Neuropediatrics, Children’s Hospital, Pequeno Príncipe, 4School of Medicine, University Positivo, Curitiba, Brazil; 5Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, US; 6Center for Health Science Research, Santa Catarina State University, Florianópolis, Brazil Background: Recent studies have suggested that children with attention-deficit hyperactivity disorder (ADHD) may benefit from computerized cognitive training. Therapy implementation is especially complicated when ADHD is associated with learning disorders (LDs). This study tested the efficacy of a computer-based cognitive training program, namely, computerized cognitive training (CCT), in children with ADHD comorbid with an LD (ADHD-LD), with or without psychostimulant medication. Materials and methods: After diagnostic evaluations, 27 children with ADHD-LD (8 unmedicated and 19 medicated) participated in CCT, which is intended to improve attention, memory, reasoning, visual processing, and executive functioning. The participants completed 24 1-hour sessions over 3 months. Neuropsychometric and standardized academic test results before and after training were compared to assess treatment efficacy. Shapiro–Wilk normality tests were applied, and subsequent Wilcoxon tests were used to identify significant differences in pre- versus post-training performance. Results: After CAT, children diagnosed with ADHD-LD showed 1) improvements in trained skills, measured directly within the software and indirectly by external psychometric tests; 2) improvements in attention, memory, and some executive functioning; 3) improvements in academic performance, particularly in mathematics; and 4) reductions in maladaptive behavioral features. Conclusion: The present findings suggest that cognitive training programs should be explored further as potential adjunctive therapies to improve outcomes in children with ADHD-LD. Keywords: attention-deficit hyperactivity disorder, attention training, computerized assessments, executive functionin