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Gepubliceerd in: Journal of Autism and Developmental Disorders 7/2016

15-03-2016 | Original Paper

The Relationship Between Clinicians’ Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder

Auteurs: Darren Hedley, Neil Brewer, Rose Nevill, Mirko Uljarević, Eric Butter, James A. Mulick

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 7/2016

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Abstract

The study examined the confidence accuracy relationship, and the influence of child characteristics on clinician confidence, when predicting a diagnosis of Autism Spectrum Disorder during screening of 125 referred children aged under 3.5 years. The diagnostic process included observation, interview, language and developmental testing. Clinical judgement accuracy was compared against final diagnosis for high and low confidence levels (with confidence assessed on a 0–100 % scale). We identified a significant CA relationship with predictive accuracy highest at confidence levels of 90–100 %. Parent report of unusual behaviors was the only significant independent predictor of confidence. Clinicians’ confidence may be important when evaluating decisions to refer, or not to refer, children for further diagnostic assessment.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Voetnoten
1
This may occur during cognitive processing. For example, Insabato et al. (2010) pose a two-stage decision mechanism where a second decision is based on confidence associated with the previous decision. More pragmatically, future decisions by other clinicians may also be influenced by earlier judgements, clinical notes, recommendations, etc.
 
2
Intellectual and developmental disability clinic (n = 15); behavioral health services (n = 7); psychological assessment (n = 1); speech services (n = 2); neurodevelopmental clinic (n = 1); physical therapy (n = 1).
 
3
We were able to assess 11 of the 33 children not referred for a diagnostic assessment with either the ADOS-2 or ADI-R. Four children did not meet ASD criteria on the ADI-R, five were under cut-off for ASD on the ADOS-2 and two children were in the low risk range but above cut-off for Autism Spectrum. Of the children who met ASD criteria on the ADOS-2, one had been assessed in the intellectual and developmental delay clinic and received a diagnosis of a language disorder and disruptive behavioral disorder; the other was not assessed further.
 
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Metagegevens
Titel
The Relationship Between Clinicians’ Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder
Auteurs
Darren Hedley
Neil Brewer
Rose Nevill
Mirko Uljarević
Eric Butter
James A. Mulick
Publicatiedatum
15-03-2016
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 7/2016
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-016-2766-9

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