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Efficacy of three screening instruments in the identification of autistic-spectrum disorders

UCL Institute of Child Health, London

Gillian Baird, FRCPCH

Guy's & St Thomas' NHS Foundation Trust, London

Emily Simonoff, MD

Institute of Psychiatry, King's College London

Tom Loucas, PhD

School of Psychology and Clinical Language Sciences, University of Reading

Susie Chandler, PhD

UCL Institute of Child Health, London, UK

David Meldrum, FACP

Chatswood Assessment Centre, Sydney, Australia

Andrew Pickles, PhD

Division of Epidemiology and Health Sciences, University of Manchester, UK

Correspondence: Tony Charman, Behavioural and Brain Sciences Unit, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. Email: t.charman{at}ich.ucl.ac.uk

Declaration of interest Funding from the Wellcome Trust and the Department of Health, UK. A.P. receives royalties from the SCQ and ADOS-G.

Background Screening instruments for autistic-spectrum disorders have not been compared in the same sample.

Aims To compare the Social Communication Questionnaire (SCQ), the Social Responsiveness Scale (SRS) and the Children's Communication Checklist (CCC).

Method Screen and diagnostic assessments on 119 children between 9 and 13 years of age with special educational needs with and without autistic-spectrum disorders were weighted to estimate screen characteristics for a realistic target population.

Results The SCQ performed best (area under receiver operating characteristic curve (AUC)=0.90; sensitivity 0.86; specificity 0.78). The SRS had a lower AUC (0.77) with high sensitivity (0.78) and moderate specificity (0.67). The CCC had a high sensitivity but lower specificity (AUC=0.79; sensitivity 0.93; specificity 0.46). The AUC of the SRS and CCC was lower for children with IQ < 70. Behaviour problems reduced specificity for all three instruments.

Conclusions The SCQ, SRS and CCC showed strong to moderate ability to identify autistic-spectrum disorder in this at-risk sample of school-age children with special educational needs.

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BJP 2007 191: 21. [Full Text]