Review article
A systematic review of screening tools in non-young children and adults for autism spectrum disorder

https://doi.org/10.1016/j.ridd.2018.05.017Get rights and content

Abstract

Background

Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures.

Aims

To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings.

Methods and Procedures

Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment.

Outcomes and Results

14 studies met the inclusion criteria, of which 11 studies were with children (4–18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included.

Conclusions and Implications

Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.

Section snippets

What this paper adds?

This systematic review of existing screening tools in non-young children and adults with Autism Spectrum Disorder (ASD) will provide broad knowledge of psychometric properties of each screening tool. Additionally, in this review, screening tools were selected through rigorous inclusion criteria – studies were only included when screening tools were examined against validated diagnostic tools, such as ADOS and ADI-R. Furthermore, targeted populations were carefully examined in this review,

Literature search strategy

To identify potentially relevant studies, we searched MEDLINE, EMBASE, PsychINFO, the Cochrane Library and CINAHL for citations from database inception through March 2017, using the following key words: (“Autism” OR “ASD” OR “Autism Spectrum Disorder” OR “Asperger syndrome” OR “pervasive developmental disorder” OR “PDD”) AND (“screening” OR “detection” OR “identification” OR “diagnosis”) AND (“ADOS” OR “autism diagnostic observational schedule” OR “ADI” OR “autism diagnostic interview”), with

Results

Our computerized search identified 947 references. Two additional publications were identified through hand-searching the references. Following removal of 42 duplicates, 848 of the 907 unique references were excluded after reviewing their title and abstract because they either did not appear to be studies validating ASD screening tools or because they did not compare the screening tool to the ADOS or the ADI-R. Of the remaining 59 studies, 44 were excluded after full text review for the

Discussion

Findings from 14 included studies, involving school-age children and adolescents (11 studies) and adults (3 studies), provide important new information on the validity of ASD screening tools. In school age children and adolescents, the SCQ and the SRS were examined in more than single studies (the SCQ in 4 studies and the SRS in 4 studies). All of these studies were conducted using clinical samples. Psychometric properties of these screening tools showed a wide range among included studies in

Conclusions

In at-risk samples of school age children and adolescents, the SCQ and the SRS seem relatively useful to identify ASD and to refer individuals scoring high on these tools to the specialists for further assessment. These screening tools may assist in differentiating ASD from other neurodevelopmental disorders and other psychiatric diagnoses. No concrete recommendations can be made on the use of other screening tools for school age children and adolescents in both general populations and clinical

Financial disclosure

The authors do not have any financial relationships relevant to this article to disclose.

Funding source

None.

Conflicts of interest

Bennett Leventhal has the following conflicts of interest to disclose: consulting for Janssen and research grant from Roche. The other authors have indicated that they have no conflicts of interest to disclose.

Contributors’ statement

Dr. Hirota conceptualized and designed the study, reviewed identified articles to determine if they met defined study inclusion and exclusion criteria, drafted the initial manuscript, and approved the final manuscript as submitted.

Dr. Epstein conceptualized and designed the study, reviewed identified articles to determine if they met defined study inclusion and exclusion criteria, critically reviewed the manuscript, and approved the final manuscript as submitted.

Dr. So reviewed identified

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