Journal of Intellectual Disability - Diagnosis and Treatment

156-163

Authors: Khaled Alkherainej, Jane Squires

An efficient approach for screening and identifying children at risk for autism spectrum disorder (ASD) remains a pressing need. The aim of this exploratory study was to examine the ability of two general developmental screening tests to identify children at risk for ASD. We compared the accuracy of one general developmental screening instrument, Ages and Stages Questionnaires (ASQ), and one general social emotional screening instrument, the Ages and Stages Questionnaire: Social Emotional (ASQ:SE), with the Social Communication Questionnaire (SCQ), an ASD-specific screening instrument. Two hundred eight children between 36 and 66 months were recruited through 19 community ASD programs, websites, and magazines. The three screening instruments were given to 285 parent/child dyads with and without a diagnosis of ASD, online via a screening website linked to a university. Sixty-four children had been diagnosed with ASD and were receiving special education services (e.g., behavioral interventions) prior to their participation. The classification agreement of the ASQ (i.e., sensitivity = 84.38%, specificity = 81.45%) outperformed the other two screening instruments; classification agreement of the SCQ was sensitivity = 70.31% and specificity = 87.33%; and of the ASQ: SE, sensitivity = 82.81% and specificity = 72.40%. Agreement among the questionnaires ranged from moderate to strong as measured by Pearson Product Moment Correlation Coefficients. Children diagnosed with ASD had scores below the screening cutoff points, indicating risk, most often on three ASQ domains: (a) communication, (b) gross motor, and (c) personal social. This exploratory study indicated the feasibility of using the ASQ in screening clinics for finding children at risk for ASD, if the ASQ is followed by specific ASD assessments. Design limitations, including a sample of children with ASD already receiving intervention services may explain the somewhat lower sensitivity of the SCQ.

177-186

Authors: Marisa Macy, Diane Bricker, Carmen Dionne, Jennifer Grisham Brown, JoAnn Johnson, Kris Slentz, Misti Waddell, Melissa Behm, Heather Shrestha

Early childhood assessment practices, procedures, and tools can lay the foundation for an effective intervention program. The purpose of this article is to report the results of a content validity study conducted on a revision of Assessment, Evaluation, and Programming System for infants and children (AEPS®) Test, a widely used early childhood assessment/evaluation instrument. A panel of early childhood and early childhood special educator experts was assembled and asked to provide qualitative feedback on the content of the revised AEPS Test. Experts were asked to address five specific questions about item content, developmental sequences, and if assessment items represented quality teaching targets for young children. Qualitative results were used to modify items, developmental sequences, and area content.

198-204

Authors: Elizabeth A. Steed A. Steed, Rashida Banerjee

This paper discusses the issues and challenges to the assessment and early identification of social emotional and behavioral issues in young children birth through five years of age in the United States. The linked system framework of social emotional assessment and intervention [1] is outlined, and recommendations for authentic assessment of social emotional development are provided to assist professionals in identifying young children early for amelioration and prevention of behavioral challenges.

213-217

Authors: Toshihiro Horiguchi, Chieko Akiyama

To determine the average medical cost incurred for early identification of intellectual and developmental disabilities in children, we retrieved the records of 264 children who had visited our consulting unit from 2005 until the end of March 2012. In the evaluation process, each child took psychological assessments and the parents were provided with solutions to enable the children to overcome their delay in school. As a whole, while the average number of visits did not differ by the diagnosis, the average medical cost differed by the diagnosis. The consultation unit was effective for gradually diminishing the medical costs incurred. Our in-clinic consultation system proved useful for early identification of intellectual and developmental disabilities in children and minimization of the medical costs incurred for the process.

230-237

Authors: Nils Haglund, SvenOlof Dahlgren, Karin Källén, Peik Gustafsson, Maria Råstam

Background:There is an increasing body of evidence that early interventions for children with Autism Spectrum Disorder (ASD) promote a positive development of social interaction. Thus, tools for early detection of ASD are warranted. Aim: Development of, and deciding cut-off-levels for, a new screening tool for ASD, the Observation Scale for Autism (OSA). The OSA was designed to be used at the free health check-up at 30 months, offered to all children in Sweden. Method: The OSA consists of 12 observations and takes less than 10 minutes to use. The performance of the test was investigated by assessing 37 children previously diagnosed ASD, 23 with Down Syndrome (DS) and 26 typically developing children (TD). Results:Children diagnosed with ASD showed statistically significant higher scores in all 12 items compared to TD children, and significantly higher in 10 items compared to the children with DS. Most of the observations in OSA seemed to cover specific symptoms of ASD, but two of the observations were more related to developmental level. The nine most discriminative items for ASD were identified, and among those, a cut-off limit was chosen (≥3 items). Among children with ASD, 34/37 reached the proposed cut off, compared to 0/26 and 4/23 among children in the TD and DS groups, respectively. Conclusion:The results suggest that the OSA discriminates children with ASD from TD children and children with DS. Using the suggested cut off, OSA provides high sensitivity for ASD (92%) with a very low false positive rate.

247-256

Authors: Joannie Busillo-Aguayo, Wendy Murawski, Ivor Weiner

Currently more than 15% of children have an emotional, behavioral, or developmental concern. In spite of recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention to conduct universal developmental surveillance and screening with children at 9, 18, and 24 months of age, fewer than 30% of children under 6 years of age ever receive a developmental screening. Children in low-income and diverse communities are even less likely to be screened by a medical provider and/or referred for further diagnostic evaluation when predictive concerns are identified. As part of a cross-agency collaborative effort involving a family resource center, a child care resource and referral agency, a regional center for developmental disabilities, and a master's degree program in early childhood education, the Mobile Developmental Screening Van Project conducted outreach to provide free developmental screening with families of children 0-8 years of age in diverse and low-income communities within the greater Los Angeles County. Using the Parent Evaluation of Developmental Status (PEDS) screening tool, 94 children were screened over the course of 6 months, with 33% showing 2 or more predictive concerns that resulted in referrals for further diagnostic evaluation. The feasibility of reaching families in hard to reach communities using a mobile screening van, as well as study limitations and recommendations for next steps, are discussed.