Article

The aim of this study was to test the accuracy of two screening instruments
in UK Community health services: Modified Checklist for Autism in Toddlers
(M-CHAT) and Social Communication Questionnaire (SCQ) for autism spectrum
disorder (ASD). A two-stage screening and in-depth assessment procedure, combined
with sampling stratification and statistical weighting, allowed the accuracy of
the screens to be estimated in the entire population of referred children.
METHOD: The study included all referrals of children aged 18 to 48 months to
community paediatric and speech and language therapy services in two London
districts over a 12-month period between September 2004 and September 2005.
Parents of 808 children were approached; screen data were obtained on 543
children (67.2%). A stratified subsample of 120 children received an in-depth
assessment for ASD as defined by the International Statistical Classification of
Diseases and Related Health Problems, 10th edition. Community clinician judgement
of likely ASD was available for 98 out of the 120 children. RESULTS: The
sensitivity and specificity were 64% (95% confidence intervals; range 51-80%) and
75% (63-85%) for the SCQ, and 82% (72-92%) and 50% (33-64%) for M-CHAT. There was
no evidence that the area under the curve differed between the two screening
instruments. There was also no evidence that clinician judgement of likely ASD
differed from either of the screening tests. The screening tests did not perform
well to confirm preliminary clinical judgement to refer (in series), nor as an
alternative indicator for referral (in parallel). INTERPRETATION: While screening
tests may provide useful information, their accuracy is moderate. Screening
information in isolation should not be used to make referral decisions regarding
specialized ASD assessment.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS