Screening for co-occurring conditions in adults with autism spectrum disorder using the strengths and difficulties questionnaire: A pilot study.
James Findon, Tim Cadman, Catherine S Stewart and 10 others
PMID 27120552WHAT IT FOUND
For people with autism spectrum disorder, parent SDQ ratings were better than self-report at spotting emotional and ADHD risk.
Parent emotional and hyperactivity ratings caught 90% and 86% of likely cases, but many caught were not true cases.
Key findings
01Parent-report SDQ emotional problems detected 90% of cases, while self-report detected 55%.
02Parent-report SDQ hyperactivity detected 86% of cases, while self-report detected 60%.
03Self-report SDQ was less specific than parent-report: hyperactivity and peer problems correlated with anxiety disorders and OCD even after impact scores were controlled.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a pilot validation study, not a definitive test of the SDQ; the authors say more systematic validation is needed. The sample was mostly higher-functioning: only 8% had an intellectual disability, compared with an estimated 40% in children and adolescents, so results may not apply to more disabled people with ASD. Participants were recruited from multiple sources, so results may not generalise to one clear service setting. Co-occurring disorders were not confirmed by a gold-standard diagnostic approach, and the comparison measures had not been validated in adults with ASD. Test-retest was done after an average 11.8 months, not the usual 1 to 4 weeks, so score changes may reflect real psychological change as well as measurement error. Not all participants had clinical notes or extra questionnaire data: 39 dyads had notes and 28 dyads had questionnaire data.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 90% and 86% detection rates as proof that the SDQ is ready for routine diagnosis. This was a pilot, parent-report still produced false positives, and self-report missed more cases.