Screening and surveillance for autism and pervasive developmental disorders

Abstract

Screening and surveillanceScreening and surveillance are diVerent but related activities involving the detection of impairments with a view to prevention or amelioration of consequent disability and handicap. Screening is the prospective identification of unrecognised disorder by the application of specific tests or examinations. Surveillance refers to the ongoing and systematic collection of data relevant to the identification of a disorder over time by an integrated health system.The review by Hall 1 in Health for all children concluded that most screening tests that set out to identify neurodevelopmental disorders do not meet the stringent criteria outlined by

Parental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based study

“…For example, SES and parental education in Cambridgeshire are generally higher than in other regions of the UK (Baron-Cohen et al, 2009).…”

“…One point is assigned for an ASC-positive response and zero for an ASC-negative response on the scored items. Thus, the total score ranges from 0 to 31 (Baron-Cohen et al, 2009). Previous pilot and validation studies have demonstrated the CAST can be used as a screening instrument in large population-based epidemiological research for ASC (Scott, Baron-Cohen, Bolton, & Brayne, 2002b;Williams, Allison et al, 2006;Williams et al, 2005).…”

“…The SCORE study used the Childhood Autism Spectrum Test (CAST) to screen for ASC in 5-10 year-old children in Cambridgeshire. In total, 136 mainstream schools within the county of Cambridgeshire, including Cambridge City, East Cambridgeshire, South Cambridgeshire and Fenland, were invited to participate in this study (Baron-Cohen et al, 2009). The first section of the CAST pack consisted of the CAST (37 items), some questions asking about medical conditions or developmental disorders (15 items) and parental concern questions from the SDQ (Goodman, 1997).…”

“…For all children who were given a diagnosis of ASC, their assessment data was re-examined and reviewed according to ICD-10 (World Health Organisation, 1993). The ADOS and ADI-R were administrated by members of the research team who were fully trained in the use of these instruments to reliability levels for research purposes (Baron-Cohen et al, 2009). The examiners had been working in our research centre for a number of validation and prevalence studies (Allison et al, 2007;Scott et al, 2002aScott et al, , , 2002bWilliams et al, 2005;Williams, Higgins, & Brayne, 2006).…”

Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder

“…Despite increasing evidence that autism can be accurately identified in very young children (Baird et al, 2001;Bryson, Rogers, & Fombonne, 2003;Charman et al, 2005;Lord et al, 2006), diagnosis is often delayed until children are of school age (Howlin & Moore, 1997;Mandell, Listerud, Levy, & Pinto-Martin, 2002;Mandell, Novak, & Zubritsky, 2005a). This delay may be due to inadequate screening practices (Dearlove & Kearney, 1990;Dobos, Dworkin, & Bernstein, 1994;Sices, Feudtner, McLaughlin, Drotar, & Williams, 2003), pediatricians' slow response to parental concerns (Glascoe, 1997;Shevell, Majnemer, Rosenbaum, & Abrahamowicz, 2001), the low sensitivity of screening instruments for autism (Dumont-Mathieu & Fein, 2005), and a general lack of awareness of symptoms (Shah, 2001).…”