Predictive properties of the A-TAC inventory when screening for childhood-onset neurodevelopmental problems in a population-based sample

BMC Psychiatry

Nóra Kerekes¹  Henrik Anckarsäter³  Clara Hellner Gumpert²  Paul Lichtenstein⁴  Maria Råstam⁶  Eva Norén Selinus²  Thomas Nilsson³  Sebastian Lundström⁵  Tomas Larson⁶ 

[1] Swedish Prison and Probation Service, Research & Development Unit, Gothenburg, Sweden;Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Gillberg Neuropsychiatry Center (GNC), University of Gothenburg, Gothenburg, Sweden;Department of Clinical Sciences, Lund University, Malmö (TL; HA), Lund (MR), Sweden

关键词: Sensitivity and specificity;    Predictive value of tests;    Cohort studies;    Co-morbidity;    Mental disorders diagnosed in childhood;    Screening;    A-TAC;    AD/HD, and other Co-morbidities inventory;    Tics;    Autism;   

Others  :  1123960
DOI  :  10.1186/1471-244X-13-233

 received in 2012-10-17, accepted in 2013-09-17,  发布年份 2013

【 摘 要 】

Background

Identifying children with childhood-onset neurodevelopmental problems (NDPs, defined here as autism spectrum disorders [ASDs], attention-deficit/hyperactivity disorder [AD/HD], tic disorders [TDs], learning disorders [LDs] and development coordination disorder), using easily administered screening instruments, is a prerequisite for epidemiological research. Such instruments are also clinically useful to prioritize children for comprehensive assessments, to screen risk groups, and to follow controls.

Autism–Tics, ADHD, and other Co-morbidities inventory (A-TAC) was developed to meet these requirements; here the A-TAC’s prospective and psychometric properties are examined, when used in a population-based, epidemiological setting.

Methods

Since 2004, parents of all Swedish twins have been asked to take part in an ongoing, nation-wide twin study (The Child and Adolescent Twin Study in Sweden). The study includes the A-TAC, carried out as a telephone interview with parents of twins aged 9 or 12. In the present study, screen-positive twins from three birth year cohorts (1993–1995) were invited to a comprehensive clinical follow-up (blinded for previous screening results) together with their co-twins and randomly selected, healthy controls at age 15 (Total N = 452).

Results

Sensitivity and specificity of A-TAC scores for predicting later clinical diagnoses were good to excellent overall, with values of the area under the receiver operating characteristics curves ranging from 0.77 (AD/HD) to 0.91 (ASDs). Among children who were screen-positive for an ASD, 48% received a clinical diagnosis of ASDs. For AD/HD, the corresponding figure was also 48%, for LDs 16%, and for TDs 60%. Between 4% and 35% of screen-positive children did not receive any diagnosis at the clinical follow-up three years later. Among screen-negative controls, prevalence of ASDs, AD/HD, LDs, and TDs was 0%, 7%, 4%, and 2%, respectively.

Conclusions

The A–TAC appeared to be a valid instrument to assess NDPs in this population-based, longitudinal study. It has good-to-excellent psychometric properties, with an excellent ability to distinguish NDPs (mainly ASDs) from non-NDPs at least three years after the screening evaluations, although specific diagnoses did not correspond closely to actual clinical diagnoses.

【 授权许可】

   
2013 Larson et al.; licensee BioMed Central Ltd.

【 图 表 】

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