ASD Screening with the Child Behavior Checklist/1.5-5 in the Study to Explore Early Development.
Susan E Levy, Leslie A Rescorla, Jesse L Chittams and 13 others
PMID 30739222WHAT IT FOUND
A CBCL/1.5-5 autism-scale score of 65 or higher flagged 0.80 of children with ASD, but it correctly did not flag only 0.50 of children with developmental delays who also had ASD features.
Key findings
01With a T score of 65 or higher, the DSM-PDP scale flagged 0.80 of children with ASD, and correctly did not flag 0.93 of population controls, 0.85 of children with developmental delays without ASD features, and 0.50 of children with developmental delays with ASD features.
02The DSM-PDP scale separated children with ASD from population controls and children with developmental delays without ASD features better than from children with developmental delays with ASD features, with overall discrimination scores of 0.95, 0.90, and 0.71.
03At the same cutoff, the Withdrawn syndrome flagged 0.66 of children with ASD and correctly did not flag 0.96, 0.91, and 0.63 of the comparison groups.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
36% of the SEED sample was excluded because children lacked CBCL data or a definitive diagnostic classification. The groups were not recruited and assessed in the same way. The ASD sample was mostly boys, and the DD-AF group tended to have low socioeconomic status. The study did not have specific information about diagnoses other than ASD or developmental delay. The original 13-item DSM-PDP scale was used because data were collected before DSM-5; one item was removed in the later version. The scale correctly did not flag only 0.50 of children with developmental delays who had ASD features.
Declared interests
One author receives remuneration from the University of Vermont Research Center for Children, Youth, and Families, which publishes the CBCL/1.5-5. Other authors reported no relevant financial relationships.
The easy way to misread this
Do not read a CBCL/1.5-5 T score of 65 or higher as an ASD diagnosis. It is a screening flag, and it correctly did not flag only 0.50 of children with developmental delays who also had ASD features.