Diagnosing Autism Spectrum Disorder: who will get a DSM-5 diagnosis? / Rachel G. KENT in Journal of Child Psychology and Psychiatry, 54-11 (November 2013)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 54-11 (November 2013) . - p.1242-1250 Titre : Diagnosing Autism Spectrum Disorder: who will get a DSM-5 diagnosis? Type de document : Texte imprimé et/ou numérique Auteurs : Rachel G. KENT, Auteur ; Sarah J. CARRINGTON, Auteur ; Ann LE COUTEUR, Auteur ; Judith GOULD, Auteur ; Lorna WING, Auteur ; Jarymke MALJAARS, Auteur ; Ilse NOENS, Auteur ; Ina VAN BERCKELAER-ONNES, Auteur ; Susan R. LEEKAM, Auteur Article en page(s) : p.1242-1250 Langues : Anglais (eng) Mots-clés : DSM-5  diagnosis  ASD  DISCO Index. décimale : PER Périodiques Résumé : Background Introduction of proposed criteria for DSM-5 Autism Spectrum Disorder (ASD) has raised concerns that some individuals currently meeting diagnostic criteria for Pervasive Developmental Disorder (PDD; DSM-IV-TR/ICD-10) will not qualify for a diagnosis under the proposed changes. To date, reports of sensitivity and specificity of the new criteria have been inconsistent across studies. No study has yet considered how changes at the ‘sub domain’ level might affect overall sensitivity and specificity, and few have included individuals of different ages and ability levels. Methods A set of DSM-5 ASD algorithms were developed using items from the Diagnostic Interview for Social and Communication Disorders (DISCO). The number of items required for each DSM-5 subdomain was defined either according to criteria specified by DSM-5 (Initial Algorithm), a statistical approach (Youden J Algorithm), or to minimise the number of false positives while maximising sensitivity (Modified Algorithm). The algorithms were designed, tested and compared in two independent samples (Sample 1, N = 82; Sample 2, N = 115), while sensitivity was assessed across age and ability levels in an additional dataset of individuals with an ICD-10 PDD diagnosis (Sample 3, N = 190). Results Sensitivity was highest in the Initial Algorithm, which had the poorest specificity. Although Youden J had excellent specificity, sensitivity was significantly lower than in the Modified Algorithm, which had both good sensitivity and specificity. Relaxing the domain A rules improved sensitivity of the Youden J Algorithm, but it remained less sensitive than the Modified Algorithm. Moreover, this was the only algorithm with variable sensitivity across age. All versions of the algorithm performed well across ability level. Conclusions This study demonstrates that good levels of both sensitivity and specificity can be achieved for a diagnostic algorithm adhering to the DSM-5 criteria that is suitable across age and ability level. En ligne : http://dx.doi.org/10.1111/jcpp.12085 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=217 [article] Diagnosing Autism Spectrum Disorder: who will get a DSM-5 diagnosis? [Texte imprimé et/ou numérique] / Rachel G. KENT, Auteur ; Sarah J. CARRINGTON, Auteur ; Ann LE COUTEUR, Auteur ; Judith GOULD, Auteur ; Lorna WING, Auteur ; Jarymke MALJAARS, Auteur ; Ilse NOENS, Auteur ; Ina VAN BERCKELAER-ONNES, Auteur ; Susan R. LEEKAM, Auteur . - p.1242-1250. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 54-11 (November 2013) . - p.1242-1250 Mots-clés : DSM-5  diagnosis  ASD  DISCO Index. décimale : PER Périodiques Résumé : Background Introduction of proposed criteria for DSM-5 Autism Spectrum Disorder (ASD) has raised concerns that some individuals currently meeting diagnostic criteria for Pervasive Developmental Disorder (PDD; DSM-IV-TR/ICD-10) will not qualify for a diagnosis under the proposed changes. To date, reports of sensitivity and specificity of the new criteria have been inconsistent across studies. No study has yet considered how changes at the ‘sub domain’ level might affect overall sensitivity and specificity, and few have included individuals of different ages and ability levels. Methods A set of DSM-5 ASD algorithms were developed using items from the Diagnostic Interview for Social and Communication Disorders (DISCO). The number of items required for each DSM-5 subdomain was defined either according to criteria specified by DSM-5 (Initial Algorithm), a statistical approach (Youden J Algorithm), or to minimise the number of false positives while maximising sensitivity (Modified Algorithm). The algorithms were designed, tested and compared in two independent samples (Sample 1, N = 82; Sample 2, N = 115), while sensitivity was assessed across age and ability levels in an additional dataset of individuals with an ICD-10 PDD diagnosis (Sample 3, N = 190). Results Sensitivity was highest in the Initial Algorithm, which had the poorest specificity. Although Youden J had excellent specificity, sensitivity was significantly lower than in the Modified Algorithm, which had both good sensitivity and specificity. Relaxing the domain A rules improved sensitivity of the Youden J Algorithm, but it remained less sensitive than the Modified Algorithm. Moreover, this was the only algorithm with variable sensitivity across age. All versions of the algorithm performed well across ability level. Conclusions This study demonstrates that good levels of both sensitivity and specificity can be achieved for a diagnostic algorithm adhering to the DSM-5 criteria that is suitable across age and ability level. En ligne : http://dx.doi.org/10.1111/jcpp.12085 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=217

DSM-5 Autism Spectrum Disorder: In search of essential behaviours for diagnosis / Sarah J. CARRINGTON in Research in Autism Spectrum Disorders, 8-6 (June 2014)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 8-6 (June 2014) . - p.701-715 Titre : DSM-5 Autism Spectrum Disorder: In search of essential behaviours for diagnosis Type de document : Texte imprimé et/ou numérique Auteurs : Sarah J. CARRINGTON, Auteur ; Rachel G. KENT, Auteur ; Jarymke MALJAARS, Auteur ; Ann LE COUTEUR, Auteur ; Judith GOULD, Auteur ; Lorna WING, Auteur ; Ilse NOENS, Auteur ; Ina VAN BERCKELAER-ONNES, Auteur ; Susan R. LEEKAM, Auteur Article en page(s) : p.701-715 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  DSM-5  Abbreviated  Diagnosis  DISCO Index. décimale : PER Périodiques Résumé : The objective of this study was to identify a set of ‘essential’ behaviours sufficient for diagnosis of DSM-5 Autism Spectrum Disorder (ASD). Highly discriminating, ‘essential’ behaviours were identified from the published DSM-5 algorithm developed for the Diagnostic Interview for Social and Communication Disorders (DISCO). Study 1 identified a reduced item set (48 items) with good predictive validity (as measured using receiver operating characteristic curves) that represented all symptom sub-domains described in the DSM-5 ASD criteria but lacked sensitivity for individuals with higher ability. An adjusted essential item set (54 items; Study 2) had good sensitivity when applied to individuals with higher ability and performance was comparable to the published full DISCO DSM-5 algorithm. Investigation at the item level revealed that the most highly discriminating items predominantly measured social-communication behaviours. This work represents a first attempt to derive a reduced set of behaviours for DSM-5 directly from an existing standardised ASD developmental history interview and has implications for the use of DSM-5 criteria for clinical and research practice. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.03.017 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=232 [article] DSM-5 Autism Spectrum Disorder: In search of essential behaviours for diagnosis [Texte imprimé et/ou numérique] / Sarah J. CARRINGTON, Auteur ; Rachel G. KENT, Auteur ; Jarymke MALJAARS, Auteur ; Ann LE COUTEUR, Auteur ; Judith GOULD, Auteur ; Lorna WING, Auteur ; Ilse NOENS, Auteur ; Ina VAN BERCKELAER-ONNES, Auteur ; Susan R. LEEKAM, Auteur . - p.701-715. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 8-6 (June 2014) . - p.701-715 Mots-clés : Autism spectrum disorder  DSM-5  Abbreviated  Diagnosis  DISCO Index. décimale : PER Périodiques Résumé : The objective of this study was to identify a set of ‘essential’ behaviours sufficient for diagnosis of DSM-5 Autism Spectrum Disorder (ASD). Highly discriminating, ‘essential’ behaviours were identified from the published DSM-5 algorithm developed for the Diagnostic Interview for Social and Communication Disorders (DISCO). Study 1 identified a reduced item set (48 items) with good predictive validity (as measured using receiver operating characteristic curves) that represented all symptom sub-domains described in the DSM-5 ASD criteria but lacked sensitivity for individuals with higher ability. An adjusted essential item set (54 items; Study 2) had good sensitivity when applied to individuals with higher ability and performance was comparable to the published full DISCO DSM-5 algorithm. Investigation at the item level revealed that the most highly discriminating items predominantly measured social-communication behaviours. This work represents a first attempt to derive a reduced set of behaviours for DSM-5 directly from an existing standardised ASD developmental history interview and has implications for the use of DSM-5 criteria for clinical and research practice. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.03.017 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=232

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