Screening for autism spectrum disorders with the brief infant-toddler social and emotional assessment.
OBJECTIVE
Using parent-completed questionnaires in (preventive) child health care can facilitate the early detection of psychosocial problems and psychopathology, including autism spectrum disorders (ASD). A promising questionnaire for this purpose is the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). The screening accuracy with regard to ASD of the BITSEA Problem and Competence scales and a newly calculated Autism score were evaluated.


METHODS
Data, that was collected between April 2010 and April 2011, from a community sample of 2-year-olds (N = 3127), was combined with a sample of preschool children diagnosed with ASD (N = 159). For the total population and for subgroups by child's gender, area under the Receiver Operating Characteristic (ROC) curve was examined, and across a range of BITSEA Problem, Competence and Autism scores, sensitivity, specificity, positive and negative likelihood ratio's, diagnostic odds ratio and Youden's index were reported.


RESULTS
The area under the ROC curve (95% confidence interval, [95%CI]) of the Problem scale was 0.90(0.87-0.92), of the Competence scale 0.93(0.91-0.95), and of the Autism score 0.95(0.93-0.97). For the total population, the screening accuracy of the Autism score was significantly better, compared to the Problem scale. The screening accuracy of the Competence scale was significantly better for girls (AUC = 0.97; 95%CI = 0.95-0.98) than for boys (AUC = 0.91; 95%CI = 0.88-0.94).


CONCLUSIONS
The results indicate that the BITSEA scales and newly calculated Autism score have good discriminative power to differentiate children with and without ASD. Therefore, the BITSEA may be helpful in the early detection of ASD, which could have beneficial effects on the child's development.
Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
Ingrid
I
Kruizinga
Karakter University Center Nijmegen, Nijmegen, the Netherlands.
Janne C
JC
Visser
Department of Psychology and Education, VU University, Amsterdam, the Netherlands.
Tamara
T
van Batenburg-Eddes
Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America.
Alice S
AS
Carter
Department of Youth Policy, Rotterdam Municipal Health Service (GGD Rotterdam-Rijnmond), Rotterdam, the Netherlands.
Wilma
W
Jansen
Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
Hein
H
Raat
D002659:Child Development Disorders, Pervasive / Q000175:diagnosis*; D002675:Child, Preschool; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016017:Odds Ratio; D010290:Parents; D011599:Psychopathology / Q000379:methods*; D012372:ROC Curve; D066107:Social Skills; D011795:Surveys and Questionnaires