Preliminary Evaluation of a Brief Autism Screener for Young Children.
Walter Zahorodny, Josephine Shenouda, Uday Mehta and 4 others
PMID 29300209WHAT IT FOUND
A brief caregiver questionnaire flagged toddlers who later received autism diagnoses, and most flagged children did have autism.
It was tested only in low-risk toddlers, so it is not yet ready to replace routine developmental surveillance.
Key findings
01In the pilot, 42 autism-diagnosed children were compared with 38 developmentally delayed and 100 typically developing children; median PDQ-1 scores were 5.0, 16.0, and 17.2.
02In the screening phase, 2007 toddlers were screened and 1959 were followed; 26 children had autism at follow-up, and among those scoring 12 or lower, 25 were screen positive, 22 had autism, and 3 did not.
03At follow-up, positive predictive value was 88%; specificity and negative predictive value ranged from 99% to 100%; sensitivity was 85% at 18 to 24 months, 71% at 25 to 30 months, and 100% at 31 to 36 months; and the 3 screen-positive children without autism all had language impairment, and 1 had cognitive impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The findings are preliminary and were obtained under informed consent with research staff, so they may not match everyday clinic conditions. Only 26 children had autism at follow-up, and 22 were identified at screening, so the test performance estimates rest on a small number of positive cases. The study excluded children with known neurologic, genetic, or developmental disorders, so it does not show how the screener performs in high-risk children. Sensitivity was lower at younger ages: 85% at 18 to 24 months and 71% at 25 to 30 months, compared with 100% at 31 to 36 months. The follow-up relied on caregiver report for some later diagnoses, and only 3 screen-positive children without autism were followed in detail. The PDQ-1 was not shown to separate autism from other developmental delays.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat the PDQ-1 as a validated universal autism screener. It was tested in low-risk toddlers under research conditions, and the authors call the findings preliminary.