Autism spectrum disorder screening with the CBCL/1½-5: Findings for young children at high risk for autism spectrum disorder.
Leslie A Rescorla, Breanna M Winder-Patel, Sarah J Paterson and 4 others
PMID 28931307WHAT IT FOUND
24-month-olds diagnosed with ASD had higher CBCL Withdrawn and DSM-PDP scores than those not diagnosed.
A score of 60 or higher identified 10 of 13, but three diagnosed children scored 50 to 51, so a normal score did not rule out ASD.
Key findings
01Children diagnosed with ASD at 24 months had mean DSM-PDP T scores of 65, compared with 50 to 51 in the low-risk and high-risk children not diagnosed.
02The Withdrawn scale had an area under the curve of 0.89 and the DSM-PDP scale had 0.91 for distinguishing children with and without an ASD diagnosis at 24 months.
03Using a T score of 60 or higher, both scales identified 10 of the 13 children diagnosed with ASD, and the three missed children scored 50 to 51.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small, and the authors describe the findings as preliminary rather than definitive. Only 13 children received an ASD diagnosis, so screening estimates depend on a small number of cases. The children were recruited as high-risk siblings or low-risk controls, not as an unselected population, and most of the comparison children had normal-range CBCL scores. The CBCL was not used to make the clinical diagnosis and was scored later by other research personnel. The sample was mostly white, and most mothers had at least a college degree, so it may not represent broader populations. The study used the DSM-IV-based 13-item DSM-PDP scale; the DSM-5 version has 12 items, although the paper says the two share 12 items and results likely would not differ markedly.
Declared interests
No author conflict of interest statement is included in the supplied text. The article is listed as supported by NIH extramural research and part of an NIH Autism Center for Excellence network.
The easy way to misread this
Do not treat a normal CBCL Withdrawn or DSM-PDP score as ruling out ASD. Three of the 13 children diagnosed with ASD at 24 months had scores of 50 to 51, and the study was a small high-risk sibling sample rather than population screening.