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

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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

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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
Date:	January 2011
Volume:	Vol.96
Number:	No.1
Number of Pages:	5
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)
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URI:	http://wrap.warwick.ac.uk/id/eprint/3697