The Library

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

Tools

Johnson, Samantha J., Hollis, Chris, Hennessy, Enid M., Kochhar, Puja, Wolke, Dieter and Marlow, Neil. (2011) Screening for autism in preterm children : diagnostic utility of the Social Communication Questionnaire. Archives of Disease in Childhood, Vol.96 (No.1). pp. 73-77. ISSN 0003-9888

PDF
WRAP_Wolke_Screening_Autism.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (182Kb)

Official URL: http://dx.doi.org/10.1136/adc.2010.194795

Abstract

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

Item Type:

Journal Article

Subjects:

R Medicine > RC Internal medicine
R Medicine > RJ Pediatrics

Divisions:

Faculty of Science > Psychology

Library of Congress Subject Headings (LCSH):

Autism spectrum disorders, Premature infants -- Development, Developmental psychobiology, Developmental psychology

Journal or Publication Title:

Archives of Disease in Childhood

Publisher:

BMJ Group

ISSN:

0003-9888

Official Date:

January 2011

Dates:

Date	Event
January 2011	Published

Volume:

Vol.96

Number:

No.1

Number of Pages:

Page Range:

pp. 73-77

Identification Number:

10.1136/adc.2010.194795

Status:

Peer Reviewed

Access rights to Published version:

Restricted or Subscription Access

Funder:

Medical Research Council (Great Britain) (MRC), National Institute for Health Research (Great Britain) (NIHR)

References:

1. Johnson S, Fawke J, Hennessy E, et al. Neurodevelopmental disability through
11 years of age in children born before 26 weeks of gestation. Pediatrics
2009 ; 124 : e249 – 57 .
2. Samara M, Marlow N, Wolke D. Pervasive behavior problems at 6 years of age
in a total-population sample of children born at </= 25 weeks of gestation.
Pediatrics 2008 ; 122 : 562 – 73 .
3. Johnson S, Hennessy E, Smith R, et al. Academic attainment and special
educational needs in extremely preterm children at 11 years of age: the EPICure
study. Arch Dis Child Fetal Neonatal Ed 2009 ; 94 : F283 – 9 .
4. Marlow N, Hennessy EM, Bracewell MA, et al. Motor and executive function at
6 years of age after extremely preterm birth. Pediatrics 2007 ; 120 : 793 – 804 .
5. Elgen I, Sommerfelt K, Markestad T. Population based, controlled study of
behavioural problems and psychiatric disorders in low birthweight children at
11 years of age. Arch Dis Child Fetal Neonatal Ed 2002 ; 87 : F128 – 32 .
6. Indredavik MS, Vik T, Heyerdahl S, et al. Psychiatric symptoms and disorders
in adolescents with low birth weight. Arch Dis Child Fetal Neonatal Ed
2004 ; 89 : F445 – 50 .
7. Kuban KC, O’Shea TM, Allred EN, et al. Positive screening on the Modifi ed
Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age
newborns. J Pediatr 2009 ; 154 : 535 – 540 .e1.
8. Limperopoulos C, Bassan H, Sullivan NR, et al. Positive screening for autism in
ex-preterm infants: prevalence and risk factors. Pediatrics 2008 ; 121 : 758 – 65 .
9. Johnson S, Hollis C, Kochhar P, et al. Autism spectrum disorders in extremely
preterm children. J Pediatr 2010 ; 156 : 525 – 31 .e2.
10. Johnson S, Marlow N. Positive screening results on the modifi ed checklist
for autism in toddlers: implications for very preterm populations. J Pediatr
2009 ; 154 : 478 – 80 .
11. Rutter M, Bailey A, Lord C. The Social Communication Questionnaire. Los
Angeles, CA: Western Psychological Services, 2003 .
12. B erument S K, Rutter M, Lord C, et al. A utism screening questionnaire:
diagnostic validity. Br J Psychiatry 1999 ; 175 : 444 – 51 .
13. C orsello C , Hus V, Pickles A, e t al. B etween a ROC and a hard place: decision
making and making decisions about using the SCQ. J Child Psychol Psychiatry
2007 ; 48 : 932 – 40 .
14. Chandler S, Charman T, Baird G, et al. Validation of the social communication
questionnaire in a population cohort of children with autism spectrum disorders.
J Am Acad Child Adolesc Psychiatry 2007 ; 46 : 1324 – 32 .
15. Charman T, Baird G, Simonoff E, et al. Effi cacy of three screening instruments
in the identifi cation of autistic-spectrum disorders. Br J Psychiatry
2007 ; 191 : 554 – 9 .
16. W itwer A N, Lecavalier L. Autism screening tools: an evaluation of the Social
Communication Questionnaire and the Developmental Behaviour Checklist-Autism
Screening Algorithm. J Intellect Dev Disabil 2007 ; 32 : 179 – 87 .
17. G oodman R , Ford T, Richards H, et al. T he Development and Well-Being
Assessment: description and initial validation of an integrated assessment of child
and adolescent psychopathology. J Child Psychol Psychiatry 2000 ; 41 : 645 – 55 .
18. Ford T, Goodman R, Meltzer H. The British Child and Adolescent Mental Health
Survey 1999: The prevalence of DSM-IV disorders. J Am Acad Child Adolesc
Psychiatry 2003 ; 42 : 1203 – 11 .
19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders. Fourth Edition. Text Revision. Washington, DC: American Psychiatric
Association 2000 .
20. Kaufman AS, Kaufman NL. Kaufman Assessment Battery for Children. Circle
Pines, MN: American Guidance Service, Inc, 1983 .
21. W olke D , Ratschinski G, Ohrt B, e t al. T he cognitive outcome of very preterm
infants may be poorer than often reported: an empirical investigation of how
methodological issues make a big difference. Eur J Pediatr 1994 ; 153 : 906 – 15 .
22. G oodman R . T he Strengths and Diffi culties Questionnaire: a research note.
J Child Psychol Psychiatry 1997 ; 38 : 581 – 6 .
23. J ohnson S , Hollis C, Kochhar P, e t al. P sychiatric disorders in extremely preterm
children: longitudinal fi nding at age 11 years in the EPICure study. J Am Acad Child
Adolesc Psychiatry 2010 ; 49 : 453 – 63 .e1.
24. Mulligan A, Richardson T, Anney RJ, et al. The Social Communication
Questionnaire in a sample of the general population of school-going children.
Ir J Med Sci 2009 ; 178 : 193 – 9 .
25. Hack M, Taylor HG, Schluchter M, et al. Behavioral outcomes of extremely low
birth weight children at age 8 years. J Dev Behav Pediatr 2009 ; 30 : 122 – 30 .
26. G lascoe F P. S creening for developmental and behavioral problems. Ment Retard
Dev Disabil Res Rev 2005 ; 11 : 173 – 9 .
27. E aves L C, Wingert H, Ho HH. Screening for autism: agreement with diagnosis.
Autism 2006 ; 10 : 229 – 42 .
28. A llen C W, Silove N, Williams K, et al. V alidity of the social communication
questionnaire in assessing risk of autism in preschool children with developmental
problems. J Autism Dev Disord 2007 ; 37 : 1272 – 8 .
29. Lee L, David AB, Rusyniak J, et al. Performance of the Social Communication
Questionnaire in children receiving preschool special education services. Res
Autism Spectr Disord 2007 ; 1 : 126 – 38 .
30. Johnson S, Wolke D, Marlow N. Developmental assessment of preterm infants
at 2 years: validity of parent reports. Dev Med Child Neurol 2008 ; 50 : 58 – 62 .
31. T owbin K E, Pradella A, Gorrindo T, et al. A utism spectrum traits in children with
mood and anxiety disorders. J Child Adolesc Psychopharmacol 2005 ; 15 : 452 – 64 .
32. G reen H , McGinnity A, Meltzer H, et al. M ental Health of Children and Young
People in Great Britain. Basingstoke, Hampshire: National Statistics, 2005 .
33. Fombonne E, Simmons H, Ford T, et al. Prevalence of pervasive developmental
disorders in the British nationwide survey of child mental health. J Am Acad Child
Adolesc Psychiatry 2001 ; 40 : 820 – 7 .
34. H eiervang E , Stormark KM, Lundervold AJ, et al. Psychiatric disorders in
Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk
factors, and service use. J Am Acad Child Adolesc Psychiatry 2007 ; 46 : 438 – 47 .
35. Posserud M, Lundervold AJ, Lie SA, et al. The prevalence of autism spectrum
disorders: impact of diagnostic instrument and non-response bias. Soc Psychiatry
Psychiatr Epidemiol 2010 ; 45 : 319 – 27 .