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Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment: Validation in a UK population-based twin sample

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Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment : Validation in a UK population-based twin sample. / McEwen, Fiona Susan; Stewart, Catherine; Colvert, Emma Jane; Woodhouse, Emma Louise; Curran, Sarah; Gillan, Nicola Claire; Lietz, Stephanie; Garnett, Tracy; Ronald, Angelica; Murphy, Declan G; Happe, Francesca Gabrielle Elizabeth; Bolton, Patrick Farrar.

In: Journal of Child Psychology and Psychiatry, Vol. 57, No. 2, 02.2016, p. 161-170.

Research output: Contribution to journalArticle

Harvard

McEwen, FS, Stewart, C, Colvert, EJ, Woodhouse, EL, Curran, S, Gillan, NC, Lietz, S, Garnett, T, Ronald, A, Murphy, DG, Happe, FGE & Bolton, PF 2016, 'Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment: Validation in a UK population-based twin sample', Journal of Child Psychology and Psychiatry, vol. 57, no. 2, pp. 161-170. https://doi.org/10.1111/jcpp.12447

APA

McEwen, F. S., Stewart, C., Colvert, E. J., Woodhouse, E. L., Curran, S., Gillan, N. C., ... Bolton, P. F. (2016). Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment: Validation in a UK population-based twin sample. Journal of Child Psychology and Psychiatry, 57(2), 161-170. https://doi.org/10.1111/jcpp.12447

Vancouver

McEwen FS, Stewart C, Colvert EJ, Woodhouse EL, Curran S, Gillan NC et al. Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment: Validation in a UK population-based twin sample. Journal of Child Psychology and Psychiatry. 2016 Feb;57(2):161-170. https://doi.org/10.1111/jcpp.12447

Author

McEwen, Fiona Susan ; Stewart, Catherine ; Colvert, Emma Jane ; Woodhouse, Emma Louise ; Curran, Sarah ; Gillan, Nicola Claire ; Lietz, Stephanie ; Garnett, Tracy ; Ronald, Angelica ; Murphy, Declan G ; Happe, Francesca Gabrielle Elizabeth ; Bolton, Patrick Farrar. / Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment : Validation in a UK population-based twin sample. In: Journal of Child Psychology and Psychiatry. 2016 ; Vol. 57, No. 2. pp. 161-170.

Bibtex Download

@article{2c1e56f24e21451e8d5ee948ee0656b7,
title = "Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment: Validation in a UK population-based twin sample",
abstract = "Background. Increasing numbers of people are being referred for the assessment of autism spectrum disorder (ASD). The NICE (UK) and the American Academy of Pediatrics recommend gathering a developmental history using a tool that operationalises ICD/DSM criteria. However, the best-established diagnostic interview instruments are time consuming, costly and rarely used outside national specialist centres. What is needed is a brief, cost-effective measure validated in community settings. We tested the Development and Well-Being Assessment (DAWBA) for diagnosing ASD in a sample of children/adolescents representative of those presenting in community mental health settings.Methods. A general population sample of twins (TEDS) was screened and 276 adolescents were selected as at low (CAST score < 12; n = 164) or high risk for ASD (CAST score ≥ 15 and/or parent reported that ASD suspected/previously diagnosed; n = 112). Parents completed the ASD module of the DAWBA interview by telephone or online. Families were visited at home: the ADI-R and autism diagnostic observation schedule (ADOS) were completed to allow a best-estimate research diagnosis of ASD to be made.Results. Development and Well-Being Assessment ASD symptom scores correlated highly with ADI-R algorithm scores (ρ = .82, p < .001). Good sensitivity (0.88) and specificity (0.85) were achieved using DAWBA computerised algorithms. Clinician review of responses to DAWBA questions minimally changed sensitivity (0.86) and specificity (0.87). Positive (0.82–0.95) and negative (0.90) predictive values were high. Eighty-six per cent of children were correctly classified. Performance was improved by using it in conjunction with the ADOS.Conclusions. The DAWBA is a brief structured interview that showed good sensitivity and specificity in this general population sample. It requires little training, is easy to administer (online or by interview) and diagnosis is aided by an algorithm. It holds promise as a tool for assisting with assessment in community settings and may help services implement the recommendations made by NICE and the American Academy of Pediatrics regarding diagnosis of young people on the autism spectrum.",
keywords = "Autism spectrum disorder, Adolescence, Assessment, Diagnosis",
author = "McEwen, {Fiona Susan} and Catherine Stewart and Colvert, {Emma Jane} and Woodhouse, {Emma Louise} and Sarah Curran and Gillan, {Nicola Claire} and Stephanie Lietz and Tracy Garnett and Angelica Ronald and Murphy, {Declan G} and Happe, {Francesca Gabrielle Elizabeth} and Bolton, {Patrick Farrar}",
year = "2016",
month = "2",
doi = "10.1111/jcpp.12447",
language = "English",
volume = "57",
pages = "161--170",
journal = "Journal of Child Psychology and Psychiatry",
issn = "0021-9630",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Diagnosing autism spectrum disorder in community settings using the Development and Well-Being Assessment

T2 - Validation in a UK population-based twin sample

AU - McEwen, Fiona Susan

AU - Stewart, Catherine

AU - Colvert, Emma Jane

AU - Woodhouse, Emma Louise

AU - Curran, Sarah

AU - Gillan, Nicola Claire

AU - Lietz, Stephanie

AU - Garnett, Tracy

AU - Ronald, Angelica

AU - Murphy, Declan G

AU - Happe, Francesca Gabrielle Elizabeth

AU - Bolton, Patrick Farrar

PY - 2016/2

Y1 - 2016/2

N2 - Background. Increasing numbers of people are being referred for the assessment of autism spectrum disorder (ASD). The NICE (UK) and the American Academy of Pediatrics recommend gathering a developmental history using a tool that operationalises ICD/DSM criteria. However, the best-established diagnostic interview instruments are time consuming, costly and rarely used outside national specialist centres. What is needed is a brief, cost-effective measure validated in community settings. We tested the Development and Well-Being Assessment (DAWBA) for diagnosing ASD in a sample of children/adolescents representative of those presenting in community mental health settings.Methods. A general population sample of twins (TEDS) was screened and 276 adolescents were selected as at low (CAST score < 12; n = 164) or high risk for ASD (CAST score ≥ 15 and/or parent reported that ASD suspected/previously diagnosed; n = 112). Parents completed the ASD module of the DAWBA interview by telephone or online. Families were visited at home: the ADI-R and autism diagnostic observation schedule (ADOS) were completed to allow a best-estimate research diagnosis of ASD to be made.Results. Development and Well-Being Assessment ASD symptom scores correlated highly with ADI-R algorithm scores (ρ = .82, p < .001). Good sensitivity (0.88) and specificity (0.85) were achieved using DAWBA computerised algorithms. Clinician review of responses to DAWBA questions minimally changed sensitivity (0.86) and specificity (0.87). Positive (0.82–0.95) and negative (0.90) predictive values were high. Eighty-six per cent of children were correctly classified. Performance was improved by using it in conjunction with the ADOS.Conclusions. The DAWBA is a brief structured interview that showed good sensitivity and specificity in this general population sample. It requires little training, is easy to administer (online or by interview) and diagnosis is aided by an algorithm. It holds promise as a tool for assisting with assessment in community settings and may help services implement the recommendations made by NICE and the American Academy of Pediatrics regarding diagnosis of young people on the autism spectrum.

AB - Background. Increasing numbers of people are being referred for the assessment of autism spectrum disorder (ASD). The NICE (UK) and the American Academy of Pediatrics recommend gathering a developmental history using a tool that operationalises ICD/DSM criteria. However, the best-established diagnostic interview instruments are time consuming, costly and rarely used outside national specialist centres. What is needed is a brief, cost-effective measure validated in community settings. We tested the Development and Well-Being Assessment (DAWBA) for diagnosing ASD in a sample of children/adolescents representative of those presenting in community mental health settings.Methods. A general population sample of twins (TEDS) was screened and 276 adolescents were selected as at low (CAST score < 12; n = 164) or high risk for ASD (CAST score ≥ 15 and/or parent reported that ASD suspected/previously diagnosed; n = 112). Parents completed the ASD module of the DAWBA interview by telephone or online. Families were visited at home: the ADI-R and autism diagnostic observation schedule (ADOS) were completed to allow a best-estimate research diagnosis of ASD to be made.Results. Development and Well-Being Assessment ASD symptom scores correlated highly with ADI-R algorithm scores (ρ = .82, p < .001). Good sensitivity (0.88) and specificity (0.85) were achieved using DAWBA computerised algorithms. Clinician review of responses to DAWBA questions minimally changed sensitivity (0.86) and specificity (0.87). Positive (0.82–0.95) and negative (0.90) predictive values were high. Eighty-six per cent of children were correctly classified. Performance was improved by using it in conjunction with the ADOS.Conclusions. The DAWBA is a brief structured interview that showed good sensitivity and specificity in this general population sample. It requires little training, is easy to administer (online or by interview) and diagnosis is aided by an algorithm. It holds promise as a tool for assisting with assessment in community settings and may help services implement the recommendations made by NICE and the American Academy of Pediatrics regarding diagnosis of young people on the autism spectrum.

KW - Autism spectrum disorder

KW - Adolescence

KW - Assessment

KW - Diagnosis

U2 - 10.1111/jcpp.12447

DO - 10.1111/jcpp.12447

M3 - Article

VL - 57

SP - 161

EP - 170

JO - Journal of Child Psychology and Psychiatry

JF - Journal of Child Psychology and Psychiatry

SN - 0021-9630

IS - 2

ER -

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