![]() ![]() Twins Early Development Study ( TEDS) and Social Relationships ( SR) Study flow chart. Parents gave informed consent at each stage of screening and assessment. ![]() ![]() The study was reviewed and approved by the Joint Schools Research Ethics Sub‐Committee for the Institute of Psychiatry and the Florence Nightingale School of Nursing and Midwifery (PNM RESC), King's College London. The sample is broadly representative of the United Kingdom in terms of maternal ethnicity (93.5% white) and education (37.9% with A‐levels or higher, the equivalent of some college education in the United States). There is no evidence that ASD‐relevant traits are elevated in twins versus singletons (Curran et al., 2011). Children in TEDS were screened and assessed at multiple time‐points from age 2 until adolescence, maximising the chances of detecting all cases of ASD in the cohort, including those with more subtle difficulties often missing from clinically ascertained samples. The sample was drawn from a large UK community‐based twin sample, the Twins Early Development Study (TEDS), which has been described elsewhere (Haworth, Davis, & Plomin, 2013). The aim of this study was to examine the effectiveness of the ASD module of the DAWBA in identifying ASD in a community sample by: (a) comparing the DAWBA to the ADI‐R as a measure of autistic symptoms (b) establishing the sensitivity, specificity, positive and negative predictive values for DAWBA diagnosis and (c) examining the improvement in detection of ASD by combining the DAWBA with an observational tool, the Autism Diagnostic Observation Schedule (ADOS Lord et al., 2000). While the DAWBA has been validated as a research tool in epidemiological settings (Goodman et al., 2000) its utility as a diagnostic tool for ASD has not been evaluated. We chose the DAWBA because: (a) it can be completed by parents online or by interview (telephone or face‐to‐face) (b) interviewers need little training, which can be done by reviewing online materials (Youth inmind, 2012) (c) it is quick to administer, the ASD module taking 20 min to complete (d) diagnosis is aided by computerised algorithm that generates a probability of disorder according to DSM‐IV and ICD‐10 criteria (e) a summary is automatically generated for each case (including probability of disorder, DSM/ICD criteria endorsed and verbatim responses to open‐ended questions) for review by clinicians. It is an online package of questionnaires designed to collect information sufficient to make a range of psychiatric diagnoses according to DSM‐IV and ICD‐10 criteria, with the ASD module gathering information required to diagnose ASD. The Development and Well‐Being Assessment (DAWBA Goodman, Ford, Richards, Gatward, & Meltzer, 2000) is a promising diagnostic tool for community settings. There is a need for simpler, cost‐effective and reliable tools to aid diagnosis in community settings. Many community services have struggled to adopt these instruments because of the level and cost of training and the time‐ and labour‐intensive nature of the interviews. The ADI‐R and DISCO are semistructured interviews carried out by highly trained clinical interviewers and take 2–3 hr to complete, whereas the 3di is a computer‐based interview that takes trained interviewers 90 min to complete. 1203).Ĭurrently, the best‐established diagnostic tools for collecting an autism‐specific history are the Autism Diagnostic Interview–Revised (ADI‐R Lord, Rutter, & Le Couteur, 1994), the Diagnostic Interview for Social Communication Disorders (DISCO Wing, Leekham, Libby, Gould, & Larcombe, 2002), and the Developmental, Dimensional and Diagnostic Interview (3di Skuse et al., 2004). Similarly, the American Academy of Pediatrics emphasised the importance of determining ‘the presence of a categorical DSM‐IV‐TR diagnosis, preferably with standardized tools that operationalize the DSM criteria’ (Johnson & Myers, 2007, p. Recognising the increased demand for diagnostic services, National Institute for Health and Clinical Excellence guidance (NICE, 2011) recommends that every autism diagnostic assessment includes ‘a developmental history, focusing on developmental and behavioural features consistent with ICD‐10 or DSM‐IV criteria’ preferably using an ‘autism‐specific tool’ (p21). Since 1990 there has been a dramatic increase in the number of children presenting for assessment for autism spectrum disorder (ASD) in the United Kingdom (Taylor, Jick, & Maclaughlin, 2013) and United States (Autism and Developmental Disabilities Monitoring Network Principal Investigators, Centers for Disease Control and Prevention, 2014). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |