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Gepubliceerd in: Journal of Autism and Developmental Disorders 8/2015

01-08-2015 | Original Paper

Efficacy of the ADEC in Identifying Autism Spectrum Disorder in Clinically Referred Toddlers in the US

Auteurs: Darren Hedley, Rose E. Nevill, Yessica Monroy-Moreno, Natalie Fields, Jonathan Wilkins, Eric Butter, James A. Mulick

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 8/2015

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Abstract

The Autism Detection in Early Childhood (ADEC) is a brief, play-based screening tool for the assessment of autism spectrum disorder (ASD) in children aged 12–36 months. We examined the psychometric properties of the ADEC in a clinical sample of toddlers (n = 114) referred to a US pediatric hospital for assessment due to concerns of developmental delay or ASD. The ADEC (cutoff = 11) returned good sensitivity (.93–.94) but poorer specificity (.62–.64) for best estimate clinical diagnosis of ASD, and compared favorably with the ADOS-2. Internal consistency was acceptable, α = .80, and inter-rater reliability was high, ICC = .95. Results support the use of the ADEC as a clinical screen for ASD.
Voetnoten
1
Developmental and other assessment data were reported when available. In some instances the research team was unable to access assessment results due to data not being provided in the child’s electronic medical records.
 
2
Confidence intervals are for the effect size when provided after Cohen’s d.
 
3
We also examined concurrent validity using partial correlations controlling for participant age and MSEL nonverbal developmental level. However, complete data sets were only available for 16 participants (df = 12). The only resultant significant correlation was between the CARS2-ST and the ADOS-2 SA, r p = .67, p = .009, and algorithm Total score, r p = .64, p = .013. The ADEC was not significantly correlated with any other instrument. We re-ran the partial correlation this time excluding the CARS2-ST and ASRS, increasing sample size to 24 (df = 20). The ADEC was significantly correlated with the ADOS-2 RRB, r p = .53, p = .011, algorithm Total score, r p = .51, p = .015, and approached significance for SA, r p = .39, p = .075, and the Severity score, r p = .37, p = .089.
 
4
As developmental level can affect validity of the ADOS-2 we examined performance in children (ASD: n = 36, M age  = 28.50, SD = 5.01 months, nonverbal DQ M = 70.38, SD = 19.05; non-ASD: n = 20, M age  = 28.98, SD = 5.34 months, nonverbal DQ M = 91.07, SD = 17.48) with a confirmed nonverbal developmental level of at least 12 (Toddler module) or 15 months (Module 1 or 2), the minimum recommended developmental age levels for the respective ADOS-2 modules (Luyster et al. 2009). However, estimates of sensitivity and specificity did not improve in this constrained sample for the ADOS-2 (all modules); Se = .97, 95 % CI [.86, 1.00], Sp = .30 [.15, .52]. For the ADEC, constraining the sample to children with a nonverbal developmental age of at least 12 months (ASD: n = 44, M age  = 28.75, SD = 4.70 months, nonverbal DQ M = 66.18, SD = 20.65; non-ASD: n = 31, M age  = 28.14, SD = 6.02 months, nonverbal DQ M = 86.71, SD = 16.84) also did not improve performance; Se = .93, [.82, .98], Sp = .58, [.41, .74].
 
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Metagegevens
Titel
Efficacy of the ADEC in Identifying Autism Spectrum Disorder in Clinically Referred Toddlers in the US
Auteurs
Darren Hedley
Rose E. Nevill
Yessica Monroy-Moreno
Natalie Fields
Jonathan Wilkins
Eric Butter
James A. Mulick
Publicatiedatum
01-08-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 8/2015
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-015-2398-5

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