Table 7.
Domain | Essential study features for interpretability: general for disability and autism screening | Additional criteria for interpretability for screening that targets children under 18 months | Recommended for consistency across studies |
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Sample/participants | Level 1: large population studies needed; track at least a subset of representative screen negatives to determine true and false negatives so that accurate Se and Sp can be calculated. Report demographic characteristics. |
Report inclusion/exclusion criteria related to other risks or other disabilities; consider % of preterm/low birthweight; suggest to exclude significant sensory, motor, and known genetic diagnoses. | |
Level 2: smaller (not population level) high-risk samples acceptable. Level 2: include samples matched on cognitive level or compare DD to ASD at outcome. Report demographic characteristics. |
Level 2: include samples matched on cognitive level and/or compare DD to ASD on outcomes. | Report inclusion/exclusion criteria related to other risks or other disabilities; see above. | |
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Screening instrument | Make administration of instrument as close as possible to how it would be used in a community setting. | ||
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Reference standard | Evaluations based on DSM criteria; in-person BED preferable. | ||
Evaluators must be blind to screening status of participants. | |||
24-month-old diagnoses may be unstable in a minority of children; 36-month diagnosis is more reliable. | 24-month-old diagnoses may be unstable in a minority of children; 36-month diagnosis is more reliable. | ||
Include and define other disability outcomes. | Define other disability outcomes consistently; consider global delay, language delay, typical development, and other disabilities. | ||
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Timing and flow | Demonstrate a “clear path” between screening outcomes and scores and reference standard diagnosis. | ||
Describe attrition. | |||
No study to date has followed children up for diagnosis after the concurrent study age or at age of 3 years. It will be important for future studies to confirm longer-term diagnostic status. | |||
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Evaluation and performance | Important to examine age groups separately; preferably in 6-month groupings up to 3 years of age. | Very important to examine young age groups separately, especially below 12 months versus 12–18 months versus 18–24 months. | Very important to examine young age groups separately, especially below 12 months versus 12–18 months versus 18–24 months. |
Very important to describe developmental level of children detected with screener. | Very important to describe developmental level of children detected with screener. | ||
Account for different levels of ASD severity. | |||
Describe other disability outcomes for false positives. |