Diagnostic Accuracy of Indian Scale for Assessment of Autism in Indian Children Aged 2–5 Years
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To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged between 2–5 years.
Study of diagnostic accuracy
Tertiary level hospital, (November 2015–November 2017).
A consecutive sample of 500 children with suspected Autism (delay or regression of developmental milestones, delay or regression in speech, age-inappropriate understanding, behaviour, play and/or social interaction) was recruited.
Each child underwent an expert comprehensive assessment of Autism (reference tool) that included history, observation, examination, diagnostic criteria for Autism Spectrum Disorder (ASD) of the Diagnostic and Statistical Manual of Mental Disorders’, 5th edition, Childhood Autism Rating Scale-2 (CARS2), developmental status and adaptive function. This was followed by the administration of ISAA (test tool) in Hindi language. Parameters of diagnostic accuracy and Receiver Operating Characteristic curves were computed.
Main Outcome Measures
ASD based on (i) expert assessment, (ii) CARS-2, and (iii) ISAA.
In children aged 2–3 years, sensitivity of ISAA was 100% (95% CI 98.2% −100%), specificity 28.9% (95% CI 17.7% to 43.4%), positive likelihood ratio 1.4 and negative likelihood ratio 0. In 3–5 year olds, sensitivity was 99.6% (95% CI 97.6% to 99.6%), specificity 33.3% (95% CI 15.1% to 58.3%), positive likelihood ration 1.5 and negative likelihood ratio 0.01. The degrees of autism based on the existing cut off values were inaccurate.
ISAA has sub-optimal performance in diagnosing and assessing severity in 2–5 year old children.
KeywordsAutism Spectrum Disorder Classification Diagnosis
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Dr Dipti Kapoor who helped in evaluation, and Ms Chetna Pal for managing study data.
Funding: None; Competing interests: None stated.
- 1.Arora NK, Nair MKC, Gulati S, Deshmukh V, Mohapatra A, Mishra D, et al. Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India. Available from: https://doi.org/10.1371/journal.pmed.1002615. Accessed August 10, 2018.CrossRefGoogle Scholar
- 2.MoHFW. National mental health survey of India, 2015–2016: summary. Available from: http://indianmhs.nimhans.ac.in/Docs/Summary.pdf. Accessed January 1, 2019.
- 6.Ministry of Social Justice and Empowerment. Scientific Report on Research Project for Development of Indian Scale for Assessment of Autism. New Delhi: Government of India; 2009.Google Scholar
- 8.Ministry of Social Justice and Empowerment. The National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disability, The National Trust Regulations, 2001. Available from: www.socialjustice.nic.in. Accessed June 23, 2014.
- 9.Notification: Guidelines for evaluation and assessment of Autism and procedure for certification. The Gazette of India, Extraordinary 2016 Apr 25; New Delhi: p. 1 (sec 1).Google Scholar
- 10.Press Information Bureau, Government of India, MOSJE, 31st August, 2016. National Workshop for Training Master Trainers in Autism Tools INCLEN and ISAA begins. Available from: http://pib.nic.in/newsite/mbErel.aspx.relid.149368. Accessed November 19, 2016.
- 15.Perumal V, Lekhra OP. Measurement of behavioural characteristics of children with autism spectrum disorders using Indian Scale for Assessment of Autism (ISAA). IJMRME 2017;3:37–45.Google Scholar
- 16.Alpern GD. Developmental Profile 3 (DP-3). Los Angeles, CA: Western Psychological Services; 2007.Google Scholar
- 17.Sparrow SS, Cicchetti VD, Balla AD. Vineland™ II, Vineland Adaptive Behavior Scales, 2nd ed. Bloomington: Psychcorp, Pearson Inc.; 2005.Google Scholar
- 19.Schopler E, ME Van Bourgondien, Wellman GJ, Love SR. The Childhood Autism Rating Scale, 2nd ed. Torrance, CA: Western Psychological Services, Inc; 2010.Google Scholar