Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay
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...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Indonesian Pediatric Society Publishing House
2024-02-01
|
| Series: | Paediatrica Indonesiana |
| Subjects: | |
| Online Access: | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3292 |
| _version_ | 1827319141786189824 |
|---|---|
| author | Nugroho Danu Setyo Handryastuti Irawan Mangunatmadja Hardiono D. Pusponegoro |
| author_facet | Nugroho Danu Setyo Handryastuti Irawan Mangunatmadja Hardiono D. Pusponegoro |
| author_sort | Nugroho Danu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-25T00:14:33Z |
| format | Article |
| id | doaj.art-6b67e0cd566d46db98b8d8e95f106414 |
| institution | Directory Open Access Journal |
| issn | 0030-9311 2338-476X |
| language | English |
| last_indexed | 2024-04-25T00:14:33Z |
| publishDate | 2024-02-01 |
| publisher | Indonesian Pediatric Society Publishing House |
| record_format | Article |
| series | Paediatrica Indonesiana |
| spelling | doaj.art-6b67e0cd566d46db98b8d8e95f1064142024-03-13T05:20:45ZengIndonesian Pediatric Society Publishing HousePaediatrica Indonesiana0030-93112338-476X2024-02-01641172110.14238/pi64.1.2024.17-213292Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delayNugroho Danu0Setyo Handryastuti1Irawan Mangunatmadja2Hardiono D. Pusponegoro3Department of Child Health, Faculty of Medicine, Universitas Brawijaya/Dr. Saiful Anwar Hospital, Malang, East JavaDivision of Neurology, Department of Child Health, Faculty of Medicine, Universitas Indonesia Dr. Cipto Mangunkusumo National Hospital, Jakarta, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, JakartaDepartment of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, JakartaBackground 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.https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3292autism spectrum disorder; children; early detection; speech delay; behavioral response |
| spellingShingle | Nugroho Danu Setyo Handryastuti Irawan Mangunatmadja Hardiono D. Pusponegoro Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay Paediatrica Indonesiana autism spectrum disorder; children; early detection; speech delay; behavioral response |
| title | Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| title_full | Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| title_fullStr | Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| title_full_unstemmed | Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| title_short | Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| title_sort | accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay |
| topic | autism spectrum disorder; children; early detection; speech delay; behavioral response |
| url | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3292 |
| work_keys_str_mv | AT nugrohodanu accuracyofbehavioralresponsesinearlydetectionofautismspectrumdisordersinchildrenaged18monthsto4yearswithspeechdelay AT setyohandryastuti accuracyofbehavioralresponsesinearlydetectionofautismspectrumdisordersinchildrenaged18monthsto4yearswithspeechdelay AT irawanmangunatmadja accuracyofbehavioralresponsesinearlydetectionofautismspectrumdisordersinchildrenaged18monthsto4yearswithspeechdelay AT hardionodpusponegoro accuracyofbehavioralresponsesinearlydetectionofautismspectrumdisordersinchildrenaged18monthsto4yearswithspeechdelay |