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Originalarbeiten/Original articles

Screening von Kindern und Jugendlichen mit hochfunktionaler Autismus-Spektrum-Störung anhand ausgewählter Items des ADI-R

Published Online:June 03, 2015https://doi.org/10.1024/1422-4917/a000354

Abstract

Fragestellung: Zum Screening von Autismus-Spektrum-Störungen (ASS) stehen verschiedene Fragebogenverfahren zur Verfügung. Leider zeigen neuere Studien, dass diese Verfahren zwar tatsächlich in der Lage sind, betroffene Personen mit ASS zu identifizieren, aber bezüglich der differentialdiagnostischen Abgrenzung zu anderen komplexen Störungsbildern (z. B. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung [ADHS], emotionale Störungen, Persönlichkeitsstörungen), insbesondere bei Personen ohne deutliche kognitive Beeinträchtigung, Probleme aufweisen (niedrige Spezifität). Methodik: In der vorliegenden Studie wurde an einer großen Inanspruchnahme-Stichprobe aus 309 Patienten (153 mit ASS, 156 mit sonstigen psychischen Störungen, IQ > 70) geprüft, inwiefern ausgewählte Items des ADI-R im Screening-Prozess von hochfunktionalen ASS eingesetzt werden können. Ergebnisse: Bei einem Cut-off von 5 zeigte sich eine hohe Sensitivität (0.93), bei einem Cut-off von 6 eine gute Spezifität (0.74). Dieses Ergebnis blieb für verschiedene Untergruppen (Einteilung nach Diagnose/Alter/IQ/Geschlecht) stabil. Schlussfolgerung: Insgesamt hat sich gezeigt, dass acht Interviewfragen des ADI-R dazu dienen können, Kinder und Jugendliche mit hochfunktionaler ASS von solchen mit anderen psychischen Störungen zu unterscheiden. Die Kombination aus früh beginnenden, ausgeprägten Auffälligkeiten im sozialen Kontakt mit stereotypen oder zwanghaft-ritualisierten Verhalten oder Interessen kann anhand weniger Fragen zu Screening-Zwecken ermittelt werden. Jedoch ist im weiteren Verlauf eine ausführliche und spezifische weitere kinder- und jugendpsychiatrische Diagnostik notwendig.


Screening interview for early detection of high-functioning autism spectrum disorders

Objective: Various different questionnaires are available for the screening of autism spectrum disorders (ASD). These screening instruments show high sensitivity and are able to identify a large number of individuals with ASD, but they lack the specificity to differentiate individuals with ASD from those children and adolescents with other complex neurobehavioural disorders (such as attention-deficit/hyperactivity disorder, emotional disorders, and others), especially for those without intellectual disabilities. Method: The present study evaluates the data of 309 individuals (153 with high-functioning ASD, 156 with other psychiatric disorders, IQ > 70) to find out whether selected items of the ADI-R can be used for an economic and sensitive screening of high-functioning ASD. Results: The results show that 8 items of the ADI-R can be used to discriminate high-functioning ASD and other psychiatric disorders. A cutoff of 5 led to a sensitivity of 0.93 and a cutoff of 6 to a specificity of 0.74. Conclusion: The combination of early onset, serious abnormalities in social contact with stereotyped or compulsive-ritualized behaviour or interests can be detected with few interview questions for screening of ASD. Nevertheless, a more detailed and specific assessment in an expert setting should follow the screening process.

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