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How useful are screening instruments for toddlers to predict outcome at age 4? General development, language skills, and symptom severity in children with a false positive screen for autism spectrum disorder

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Abstract

Screening instruments for autism spectrum disorder (ASD) often generate many false positives. It is argued that these children may have other developmental difficulties and are also in need of thorough assessment and early intervention. The current study looked at the predictive validity of positive screens on the Checklist for Early Signs of Developmental Disorders (CESDD) and the Early Screening of Autistic Traits questionnaire (ESAT) at age 2 towards language, cognitive function, and symptom severity at age 4. Children who screened positive on the ESAT scored lower for both language and cognitive functioning at age 4 compared with children who screened negative on the ESAT. Also, the more signs of ASD that were recognized on the CESDD or ESAT, the lower the scores for language and cognitive functioning at age 4. False positive screens could be differentiated from true positive screens on the CESDD only in symptom severity score on the Autism Diagnostic Observation Schedule (ADOS). It seems that early screeners for ASD also detect children with other developmental disorders and that diagnostic instruments such as the ADOS are warranted to differentiate between children with ASD and other developmental problems.

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Acknowledgments

Partial funding for this research was provided by support from Steunpunt Expertisenetwerken and Vlaamse Vereniging Autisme. We thank the day-care centres, the children and their families for their participation to the study. Special thanks goes to the participating diagnostic centra across Flanders (COS and RCA Gent, COS and RCA Antwerpen, COS and RCA Brussel, COS and ECA Leuven).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was approved by the ethics committee of the Faculty of Psychology and Educational Sciences of Ghent University, where the study was conducted.

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Authors and Affiliations

  1. Research Group Developmental Disorders, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium

    Mieke Dereu, Herbert Roeyers, Ruth Raymaekers, Mieke Meirsschaut & Petra Warreyn

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  1. Mieke Dereu
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  2. Herbert Roeyers
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Correspondence to Mieke Dereu.

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Dereu, M., Roeyers, H., Raymaekers, R. et al. How useful are screening instruments for toddlers to predict outcome at age 4? General development, language skills, and symptom severity in children with a false positive screen for autism spectrum disorder. Eur Child Adolesc Psychiatry 21, 541–551 (2012). https://doi.org/10.1007/s00787-012-0280-y

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