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Diagnostic Accuracy of Indian Scale for Assessment of Autism in Indian Children Aged 2–5 Years

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Abstract

Objective

To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged between 2–5 years.

Design

Study of diagnostic accuracy

Setting

Tertiary level hospital, (November 2015–November 2017).

Participants

A consecutive sample of 500 children with suspected Autism (delay or regression of developmental milestones, delay or regression in speech, age-inappropriate understanding, behaviour, play and/or social interaction) was recruited.

Procedure

Each child underwent an expert comprehensive assessment of Autism (reference tool) that included history, observation, examination, diagnostic criteria for Autism Spectrum Disorder (ASD) of the Diagnostic and Statistical Manual of Mental Disorders’, 5th edition, Childhood Autism Rating Scale-2 (CARS2), developmental status and adaptive function. This was followed by the administration of ISAA (test tool) in Hindi language. Parameters of diagnostic accuracy and Receiver Operating Characteristic curves were computed.

Main Outcome Measures

ASD based on (i) expert assessment, (ii) CARS-2, and (iii) ISAA.

Results

In children aged 2–3 years, sensitivity of ISAA was 100% (95% CI 98.2% −100%), specificity 28.9% (95% CI 17.7% to 43.4%), positive likelihood ratio 1.4 and negative likelihood ratio 0. In 3–5 year olds, sensitivity was 99.6% (95% CI 97.6% to 99.6%), specificity 33.3% (95% CI 15.1% to 58.3%), positive likelihood ration 1.5 and negative likelihood ratio 0.01. The degrees of autism based on the existing cut off values were inaccurate.

Conclusions

ISAA has sub-optimal performance in diagnosing and assessing severity in 2–5 year old children.

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Acknowledgements

Dr Dipti Kapoor who helped in evaluation, and Ms Chetna Pal for managing study data.

Funding

Funding: None; Competing interests: None stated.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, India

    Sharmila Banerjee Mukherjee, Satinder Aneja, Suvasini Sharma & Meenakshi Sharma

Authors
  1. Sharmila Banerjee Mukherjee
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  2. Satinder Aneja
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  3. Suvasini Sharma
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  4. Meenakshi Sharma
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Contributions

Contributors: SBM, SA: conceptualized the study. SBM, SA, SS: were the neuro-developmental experts; SBM: performed the comprehensive evaluation and quality check; MS: helped in collection and analysis of the data pertaining to ISAA; SBM: carried out the literature search, interpreted the data and drafted the manuscript which underwent a critical appraisal by SA, SS and MS. All the authors approved the final version of manuscript, and agree to be held accountable for all aspects of the work.

Corresponding author

Correspondence to Sharmila Banerjee Mukherjee.

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Mukherjee, S.B., Aneja, S., Sharma, S. et al. Diagnostic Accuracy of Indian Scale for Assessment of Autism in Indian Children Aged 2–5 Years. Indian Pediatr 56, 831–836 (2019). https://doi.org/10.1007/s13312-019-1608-1

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  • DOI: https://doi.org/10.1007/s13312-019-1608-1

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