Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay

Bibliographic Details
Title: Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay
Authors: Nugroho Danu, Setyo Handryastuti, Irawan Mangunatmadja, Hardiono D. Pusponegoro
Source: Paediatrica Indonesiana, Vol 64, Iss 1, Pp 17-21 (2024)
Publisher Information: Indonesian Pediatric Society Publishing House, 2024.
Publication Year: 2024
Collection: LCC:Medicine
LCC:Pediatrics
Subject Terms: autism spectrum disorder, children, early detection, speech delay, behavioral response, Medicine, Pediatrics, RJ1-570
More Details: Background Early detection of autism spectrum disorders (ASD) in children with speech delay is important to improve outcomes. Behavioral responses to calling, teasing, poking, and blocking can be used to screen for ASD in daily practice. Objective To evaluate the accuracy of behavioral responses to stimuli in detecting ASD in children aged 18 months to 4 years with speech delay. Methods This cross-sectional study was conducted in children with speech delay aged 18 months to 4 years who visited the Outpatient Clinic of Cipto Mangunkusumo Hospital, Jakarta. Subjects were stimulated while playing by poking, teasing, calling, and blocking (stopping the child’s play using the examiner’s hand) and were assessed for their responses. Lack of seeking eye contact with the examiner following the stimulus was considered as a response suggestive of ASD. Independent diagnosis based on DSM-V criteria was considered the gold standard to diagnose ASD or non-ASD. Results A total of 109 children were included in this study, with an average age of 32 (SD 7.4) months. There were 52 subjects (47.7%) with ASD and 57 subjects (52.2%) with non-ASD. Behavioral response analysis revealed that calling, blocking and teasing had high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying ASD. The poking response had the highest specificity to rule out ASD compared to other stimuli, with 75% sensitivity (95%CI 63.2% to 86.7%), 93% specificity (95%CI 86.3% to 99.6%), 90% PPV (95%CI 82% to 99.3%), and 80% NPV (95%CI 70.7% to 89.9%). When all behavioral responses were combined, with lack of a response to all four stimuli considered suggestive of ASD, we obtained 100% specificity, 42% sensitivity, 100% PPV and 65% NPV. Conclusion The combination of behavioral responses had high specificity, sensitivity, PPV, and NPV for early detection of ASD in children with speech delay.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 0030-9311
2338-476X
Relation: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3292; https://doaj.org/toc/0030-9311; https://doaj.org/toc/2338-476X
DOI: 10.14238/pi64.1.2024.17-21
Access URL: https://doaj.org/article/6b67e0cd566d46db98b8d8e95f106414
Accession Number: edsdoj.6b67e0cd566d46db98b8d8e95f106414
Database: Directory of Open Access Journals
More Details
ISSN:00309311
2338476X
DOI:10.14238/pi64.1.2024.17-21
Published in:Paediatrica Indonesiana
Language:English